Serum levels of the soluble receptor for tumor necrosis factor in patients with renal disease

Abstract

Tumor necrosis factor-alpha (TNF-alpha) has been found to be elevated in patients during hemodialysis and is thought to mediate some of the immune and metabolic dysfunctions in these patients. It has been speculated that infusions of soluble TNF receptor (sTNF-R) may prevent some of the cytotoxic effects of TNF. However, little is still known about preexisting serum TNF-R levels in patients with chronic renal failure, with or without hemodialysis. Therefore we analyzed serum samples of sTNF-R in 26 patients with chronic renal failure (group I), 61 hemodialysis patients (group II), 9 renal transplant recipients with acute renal failure requiring posttransplant dialysis (group III), 13 renal transplant patients with rejection and moderate kidney dysfunction (group IV), and 21 renal transplant recipients with borderline kidney dysfunction and diverse infectious complications (group V). Control groups consisted of 34 blood donors and diseased controls (11 renal transplant recipients with normal kidney function without complications). All patient groups showed significantly higher sTNF-R levels compared to the control groups. In groups I, IV, and V comparable levels were observed. In group I there was a clear correlation between sTNF-R levels and serum creatinine. The highest sTNF-R serum levels were seen in groups II and III, but there was no correlation with creatinine. In the posttransplant cases (group III and diseased controls) there was a decrease in sTNF-R with improvement of kidney function. These data strongly suggest that sTNF-R serum levels are dependent on kidney function.

Serum Concentration of IL-2, IL-6, TNF-Alpha and Their Soluble Receptors in Children on Maintenance Hemodialysis

“…Our results, which showed a significant increase in the sTNF RI concentration as compared to healthy controls, confirm the data from studies performed in adult HD patients [4, 40, 41, 42, 43]. One of the mechanisms leading to an increased blood concentration of this peptide is diminished renal clearance due to CRF resulting in passive accumulation of sTNF RI.…”

Added Value of Soluble Tumor Necrosis Factor-α Receptor 1 as a Biomarker of ESRD Risk in Patients With Type 1 Diabetes

“…The median level of soluble TNFaR 1 was 2.0 ng/mL in patients with overt nephropathy, similar to that reported in previous studies (2)(3)(4)(5)(6)(7)(8)(9). Circulating levels of soluble TNFaR 1 were highly correlated with eGFR (R 2 = 0.69) (Supplementary Fig.…”

“…1B and Supplementary Table 2). Notably, however, the cause-specific (Cox) model had statistical (overall fit) advantage compared with the competing risk (Fine-Gray) model, as assessed by the difference in respective BIC (1,256 vs. 1,220; threshold for difference of [5][6][7][8][9][10]. This may be understood in that the cause-specific Cox model has inferential advantage with respect to pathophysiology, whereas in a therapeutic/trial sense, a competing risk model may be apposite.…”

Association between graft function and serum TNF-α, TNFR1 and TNFR2 levels in patients with kidney transplantation

“…The soluble TNFR levels have been reported to be increased during acute rejection. [20][21][22][23][24] In accordance with these studies, we observed significant elevation of serum TNFR2 levels in acute rejection. Regarding ROC analysis for estimating acute rejection, serum TNFR1 and TNFR2 levels determined on 7th day and first month have highest sensitivity and specificity in our study.…”