Grzegorzewska Alicja E, Mlot Monika
Department of Nephrology, Transplantology and Internal Diseases, Karol Marcinkowski University of Medical Sciences, Poznan, Poland.
Adv Perit Dial. 2003;19:67-72.
Our aim in the present study was to simultaneously determine, in peritoneal dialysis (PD) patients, interleukin-15 (IL-15) concentrations in serum and dialysate, peritoneal transport parameters, and ultrafiltration (UF). The study was performed in 42 patients who had been treated with PD for 24.5 +/- 20.1 months. Concentration of IL-15 was measured (ELISA: IBL, Hamburg, Germany) during a peritoneal equilibration test. Of 42 patients, 69% had serum IL-15 concentrations above normal values (< 13.0 pg.mL). The mean dialysate-to-plasma ratio (D/P) for IL-15 exceeded 1. We observed a negative relationship between dialysate IL-15 and effluent volume. Patients with UF < or = 200 mL or < 100 mL had higher dialysate IL-15 concentration, higher D/P for IL-15, higher mass transfer area coefficient (KBD) for creatinine, and higher dialysate creatinine concentration than patients with more UF. The KBD for creatinine correlated negatively with dialysate effluent volume. We conclude that, in PD patients, elevated serum and dialysate IL-15 concentrations confirm the existence of systemic and local inflammation; the source of IL-15 in dialysate is not only serum, but also local generation in the peritoneum; and dialysate IL-15 concentration may be a marker of UF capacity.
我们在本研究中的目的是同时测定腹膜透析(PD)患者血清和透析液中的白细胞介素-15(IL-15)浓度、腹膜转运参数及超滤(UF)情况。该研究纳入了42例接受PD治疗24.5±20.1个月的患者。在腹膜平衡试验期间测量IL-15浓度(酶联免疫吸附测定法:德国汉堡IBL公司)。42例患者中,69%的血清IL-15浓度高于正常值(<13.0 pg/mL)。IL-15的平均透析液与血浆比值(D/P)超过1。我们观察到透析液IL-15与流出液量之间呈负相关。超滤量≤200 mL或<100 mL的患者比超滤量更多的患者具有更高的透析液IL-15浓度、更高的IL-15的D/P、更高的肌酐物质转运面积系数(KBD)以及更高的透析液肌酐浓度。肌酐的KBD与透析液流出液量呈负相关。我们得出结论,在PD患者中,血清和透析液IL-15浓度升高证实存在全身和局部炎症;透析液中IL-15的来源不仅是血清,还有腹膜局部产生;且透析液IL-15浓度可能是超滤能力的一个标志物。