慢性血液透析患者酸中毒与细胞因子分泌和炎症标志物的关系。

Cytokine secretion and markers of inflammation in relation to acidosis among chronic hemodialysis patients.

机构信息

Department of Nephrology and Hypertension, Rabin Medical Center-Hasharon Hospital, Petah Tikva, Israel.

出版信息

Blood Purif. 2013;35(1-3):181-6. doi: 10.1159/000346689.

DOI:10.1159/000346689

PMID:23463880

Abstract

BACKGROUND

Various cytokines are increased in hemodialysis (HD) patients, and are considered prognostic markers. Metabolic acidosis is common among chronic HD patients and is associated with survival. The relationship between acidosis and cytokines in HD patients has not been fully explored. The study aim was to measure pro- and anti-inflammatory cytokines in HD patients, with relation to bicarbonate levels.

METHODS

Forty-seven stable HD patients were included (male/female 28/19, mean age 70.4 ± 14.5 years). Blood tests were taken before a midweek dialysis session. Cytokine secretion from peripheral blood mononuclear cells was measured.

RESULTS

Acidosis versus no acidosis (serum HCO3 – 21.5 ± 0.2 vs. 24.9 ± 0.3 mEq/l, p < 0.001) was associated with decreased secretion of the anti-inflammatory interleukin-10 (IL-10, 1.16 ± 0.11 vs. 1.71 ± 0.20 ng/ml, p = 0.023). Patients with acidosis had higher parathyroid hormone (PTH), calcium-phosphate product, protein intake and transferrin. Higher IL-10 was associated with increased IL-6 secretion, higher bicarbonate, younger age and lower PTH.

CONCLUSIONS

In stable chronic HD patients, a possible direct relation exists between metabolic acidosis and IL-10.

摘要

背景

各种细胞因子在血液透析（HD）患者中增加，被认为是预后标志物。代谢性酸中毒在慢性 HD 患者中很常见，与生存率相关。酸中毒与 HD 患者细胞因子之间的关系尚未得到充分探讨。本研究旨在测量 HD 患者的促炎和抗炎细胞因子，并与碳酸氢盐水平相关。

方法

纳入 47 例稳定的 HD 患者（男/女 28/19，平均年龄 70.4 ± 14.5 岁）。在每周透析期间采集血液样本。测量外周血单核细胞的细胞因子分泌情况。

结果

酸中毒与无酸中毒（血清 HCO3- 21.5 ± 0.2 vs. 24.9 ± 0.3 mEq/l，p < 0.001）与抗炎细胞因子白细胞介素-10（IL-10）的分泌减少相关（1.16 ± 0.11 vs. 1.71 ± 0.20 ng/ml，p = 0.023）。酸中毒患者甲状旁腺激素（PTH）、钙磷乘积、蛋白质摄入和转铁蛋白水平较高。较高的 IL-10 与较高的 IL-6 分泌、较高的碳酸氢盐、较年轻的年龄和较低的 PTH 相关。