Nephrology, Dialysis and Transplantation, University and Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy.
Clin Biochem. 2013 Jan;46(1-2):103-8. doi: 10.1016/j.clinbiochem.2012.10.014. Epub 2012 Oct 22.
Acute kidney injury (AKI) is associated with a high mortality and morbidity rate. In this study we investigated whether dialysis membranes influence the recovery of renal function, through the regulation of hepatocyte growth factor (HGF).
21 patients were enrolled and assigned to hemodialysis (HD) with cellulose (CE, N=11) versus polymethylacrylate (PMMA, N=10) membranes in alternating order. HGF and IL-1 were measured in serum and in peripheral blood mononuclear cells (PBMC) supernatants collected immediately before the first HD session (T0), at 15 minutes (T15), at 240 minutes (T240) and after the last HD, when renal recovery occurred. Eight healthy volunteers were the controls (CON).
Time to renal function recovery was lower in CE than in PMMA patients. Serum HGF in HD patients was significantly higher than in CON. HGF levels were higher in CE than in PMMA patients at T15 (13.4±2.7 vs 8.9±3.0 ng/mL, P=0.004) and T240. At recovery, HGF levels decreased. IL-1 serum levels showed a similar trend (at T15 CE: 20.5±2.9 vs PMMA: 16.9±3.2 pg/mL, P=0.005). HGF release significantly increased in the course of HD, resulting in higher levels in CE than that in PMMA patients. Considering all the patients, basal HGF release negatively correlated with time to renal recovery (r2=0.42, P<0.01).
Here we demonstrated that dialysis membranes influence the cytokine profile in AKI patients, HGF release being higher in patients treated with the CE membrane, in comparison to PMMA. Our results suggest that treatment with CE might improve clinical outcomes, possibly through increased release of HGF.
急性肾损伤（AKI）与高死亡率和发病率相关。本研究通过检测肝细胞生长因子（HGF），探讨透析膜是否通过调节其功能而影响肾功能的恢复。
共纳入 21 例患者，按交替顺序分别接受纤维素（CE，n=11）和聚甲基丙烯酸甲酯（PMMA，n=10）透析膜行血液透析（HD）。分别于首次 HD 治疗前（T0）、15 分钟（T15）、240 分钟（T240）及最后一次 HD 后（当肾功能恢复时），采集患者血清和外周血单个核细胞（PBMC）上清液，检测 HGF 和白细胞介素 1（IL-1）。另外，选择 8 例健康志愿者作为对照组（CON）。
与 PMMA 组相比，CE 组患者肾功能恢复时间更短。HD 患者血清 HGF 水平明显高于 CON 组。与 PMMA 组相比，CE 组患者在 T15（13.4±2.7 vs 8.9±3.0 ng/ml，P=0.004）和 T240 时 HGF 水平更高。在恢复时，HGF 水平下降。血清 IL-1 水平也呈类似趋势（T15 时 CE 组：20.5±2.9 vs PMMA 组：16.9±3.2 pg/ml，P=0.005）。HD 过程中 HGF 释放显著增加，导致 CE 组患者的 HGF 水平高于 PMMA 组。考虑到所有患者，基础 HGF 释放与肾功能恢复时间呈负相关（r2=0.42，P<0.01）。
本研究表明，透析膜影响 AKI 患者的细胞因子谱，与 PMMA 相比，CE 膜治疗的患者 HGF 释放更高。我们的研究结果提示，CE 治疗可能通过增加 HGF 的释放而改善临床结局。
