Effects of ultrapure and non-sterile dialysate on the inflammatory response during in vitro hemodialysis

Tielemans, Christian; Husson, Cécile; Schurmans, Thierry; Gastaldello, Karine; Madhoun, Philippe; Delville, Jean‐Pierre; Marchant, Arnaud; Goldman, Michel; Vanherweghem, Jean‐Louis

doi:10.1038/ki.1996.33

Cited by 72 publications

(53 citation statements)

References 38 publications

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“…Furthermore, the amount of IL-1β appeared independent of the bacterial quality of the dialysate. Hence, in contrast with the changes in expression of cell surface molecules, cytokine release by dialyser-adherent cells appears to depend largely on the material of the device [35]. As for the latter finding, comparable data have been published recently [36].…”

Section: Discussionsupporting

confidence: 71%

Monocyte Activation in Peripheral Blood and Dialyser Eluates: Phenotypic Profile and Cytokine Release

Schouten

Grooteman²,

Schoorl

et al. 2002

Nephron

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Background/Aims: Monocyte activation and subsequent cytokine generation is presumed to be involved in haemodialysis (HD)-related morbidity. The present study was designed to investigate HD-induced changes in monocytes, with respect to their phenotypic profile and cytokine release, both in peripheral blood (PB) and dialyser eluates (DE). In addition, the effect of the type of dialyser on monocyte activation was assessed. Methods: Dialyser elution was performed in 8 patients after 3 h of HD, using cuprammonium (CU) and polysulfon (PS) dialysers in a randomised cross-over design. PB samples and DE were analysed for both the expression of a variety of monocyte cell surface markers (CD62L, CD11b, CD25, HLA-DR, CD64 and CD14) by flow cytometry and IL-1β levels. Monocytes were identified by dual labelling with antibodies against CD14. Results: In PB, the expression of CD11b increased during HD with both devices, but was more pronounced with CU (CU versus PS: p < 0.05). CD62L decreased during HD, but only significantly for PS (p < 0.02). HLA-DR was downregulated during HD with CU (p = 0.056). The expression of CD64 was higher during HD with CU (p = 0.02). Finally, CD14 increased during HD with both dialysers (p < 0.03). DE yielded a mean cell count of 51 × 10⁶ cells. The proportion of monocytes in DE was 3% for CU and 4% for PS. In eluted monocytes, a significant upregulation of CD11b, CD25, and HLA-DR was observed. CD62L was downregulated when compared to PB at t₁₈₀ (p < 0.001). In DE, no correlation was found between the type of dialyser and the phenotypic changes. In 10 of 16 DE supernatants, 6 CU and 4 PS, IL-1β release could be demonstrated, CU yielding significantly more of this cytokine than PS (p = 0.03). Conclusions: According to both their phenotypic profile and cytokine release, monocytes sticking to the dialyser membrane after HD are considerably more activated than circulating monocytes. Activation of eluted monocytes appeared independent of the type of dialyser, suggesting an effect of mechanical stress rather than bioincompatibility. In contrast, phenotypic activation of peripheral blood monocytes and cytokine release in the DE supernatant were mainly dialyser-dependent.

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Section: Discussionsupporting

confidence: 71%

Monocyte Activation in Peripheral Blood and Dialyser Eluates: Phenotypic Profile and Cytokine Release

Schouten

Grooteman²,

Schoorl

et al. 2002

Nephron

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“…The origin of inflammation in these patients has not been clearly identified. It has been suggested that the dialysis procedure per se may account for the inflammation [6,7,8,9]. However, dialysis is unlikely to be solely responsible for this, as raised CRP levels are relatively common in patients with chronic renal failure (CRF) prior to the initiation of dialysis [10,11,12,13].…”

Section: Introductionmentioning

confidence: 99%

Serum C-reactive Protein Level Is Associated with Renal Function and It Affects Echocardiographic Cardiovascular Disease in Pre-Dialysis Patients

Ateş

Yılmaz²,

Kutlay³

et al. 2005

Nephron Clin Pract

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Background: Relevance of serum CRP for morbidity and mortality in pre-dialysis patients has not been assessed extensively. The aim of this study was to determine the incidence of elevated serum CRP in pre-dialysis patients and to identify the factors that associate with serum CRP. We were also evaluated the effects of serum CRP on cardiovascular disease, anemia, and nutritional markers. Methods: One hundred and eight pre-dialysis patients with a mean creatinine clearance (CrCl) of 30.1 ml/min were included in the study. Data collected from each patient included demographics, co-morbidity, medications, blood pressures, blood biochemistry including serum CRP, renal function, and echocardiography. Results: Serum CRP was elevated (>5 mg/l) in 43 patients (39.8%). There was a negative correlation between serum CRP and CrCl (r = –0.370, p < 0.001). CrCl was the unique independent factor affecting serum CRP. Serum CRP was an independent factor affecting left ventricular mass index, fractional shortening, serum albumin and hematocrit in multivariate analyses. Conclusions: Prevalence of elevated serum CRP in pre-dialysis patients is high. Reduced renal clearance of CRP and/or cytokines may contribute to the inflammatory status. Elevated serum CRP is an important cause of morbidity in pre-dialysis patients.

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“…In previous reports [8, 10], we have shown that culture with CU membrane induces apoptosis in human monocytes. After 48 h of culture with the CU membrane, 47 ± 9% of the THP-1 cells undergo apoptosis (fig.…”

Section: Resultsmentioning

confidence: 99%

“…During hemodialysis with bioincompatible membranes such as Cuprophan (CU), activation of mononuclear cells results in cytokine release [1, 2, 3, 4], expression of adhesion molecules [5, 6, 7, 8], and formation of cell aggregates, and some cells undergo apoptosis [9, 10]. The mechanism(s) by which hemodialysis membranes induce mononuclear cell activation are not completely understood.…”

Section: Introductionmentioning

confidence: 99%

Role of Adhesion Molecules in Mononuclear Cell Apoptosis Induced by Cuprophan Hemodialysis Membranes

Carracedo

Ramı́rez²,

Martín‐Malo³

et al. 2001

Nephron

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Background/Aim: Hemodialysis with Cuprophan (CU) membranes induces mononuclear cell activation, leading to increased expression of adhesion molecules, formation of cell aggregates, and apoptosis. It is likely that structure(s) of the CU membrane interact with mononuclear cell surface molecules which transduce biochemical signals to the cell. Interactions between adhesion molecules and extracellular matrix have been implicated in cell activation, proliferation, and/or apoptosis. In the present work, we study whether adhesion molecules may be involved in CU-induced mononuclear cell aggregation and/or apoptosis. Methods: The present study was performed using THP-1 cells, a human monocytic cell line, cultured in the presence of the CU membrane. CD11b and CD54 expression was studied with fluorescent monoclonal antibodies. Cell aggregation was quantified using a phase-contrast microscope. Apoptosis was evaluated by either light microscopy or annexin V labeling. Results: The results show that incubation of CU membranes with the proteins CD11b, CD18, and CD54 or the blockade of these cell surface molecules with specific monoclonal antibodies inhibited the CU-induced aggregation and apoptosis in a dose-dependent manner. Conclusion: These results suggest that CU membranes interact selectively with these specific proteins to induce cell activation which ultimately results in apoptosis.

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Effects of ultrapure and non-sterile dialysate on the inflammatory response during in vitro hemodialysis

Cited by 72 publications

References 38 publications

Monocyte Activation in Peripheral Blood and Dialyser Eluates: Phenotypic Profile and Cytokine Release

Monocyte Activation in Peripheral Blood and Dialyser Eluates: Phenotypic Profile and Cytokine Release

Serum C-reactive Protein Level Is Associated with Renal Function and It Affects Echocardiographic Cardiovascular Disease in Pre-Dialysis Patients

Role of Adhesion Molecules in Mononuclear Cell Apoptosis Induced by Cuprophan Hemodialysis Membranes

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