Nephrology Unit, Magna Graecia University, Catanzaro, Italy.
J Nephrol. 2009 Nov-Dec;22(6):760-5.
Cooler temperature dialysate (TD) has gained in popularity in the treatment of hypotension during hemodialysis (HD). In this study we verified the hypothesis of an eventual involvement of cytokines.
Four patients on regular HD underwent two 4-hour HD sessions once at 37 degrees C TD and once at 35 degrees C TD. The concentration of the cytokines (cyt) IL-1, IL-2, IL-8, IL-12 and tumor necrosis factor-alpha (TNF-alpha) was measured before the HD session initiation and after 20, 60, 120 and 240 minutes. Body temperature, weight, blood pressure and heart rate were registered at the same time points.
We found a higher blood pressure at 35 degrees C but no intradialytic differences in cyt concentration at 35 degrees C or 37 degrees C. The percentage changes of cyt from baseline were very slight, except for IL-8 which decreased by 40% both at 35 degrees C and 37 degrees C.
These preliminary results suggest that cytokines do not seem play a relevant role in determining the favorable effects of cooler TD on blood pressure. Our study is preliminary and our results need to be confirmed by other studies.
在血液透析(HD)期间治疗低血压时,较冷的透析液(TD)温度越来越受欢迎。在这项研究中,我们验证了细胞因子最终可能参与的假设。
4 名常规 HD 患者接受了两次 4 小时 HD 治疗,一次在 37°C TD,一次在 35°C TD。在 HD 治疗开始前和 20、60、120 和 240 分钟后,测量细胞因子(cyt)IL-1、IL-2、IL-8、IL-12 和肿瘤坏死因子-α(TNF-α)的浓度。同时记录体温、体重、血压和心率。
我们发现 35°C 时血压较高,但 35°C 或 37°C 时细胞因子浓度无差异。细胞因子从基线的百分比变化非常小,除了 IL-8,它在 35°C 和 37°C 时均降低了 40%。
这些初步结果表明,细胞因子似乎在决定较冷 TD 对血压的有利影响方面不起重要作用。我们的研究是初步的,我们的结果需要其他研究来证实。