Ma Jie, Dou Yanna, Zhang Hanjie, Thijssen Stephan, Williams Schantel, Kuntsevich Viktoriya, Ouellet Georges, Wong Michelle M Y, Persic Vanja, Kruse Anja, Rosales Laura, Wang Yuedong, Levin Nathan W, Kotanko Peter
Renal Research Institute, New York, NY, USA.
Blood Purif. 2017;43(1-3):200-205. doi: 10.1159/000452728. Epub 2017 Jan 24.
The pathogenesis of anemia in hemodialysis (HD) patients is dependent on multiple factors, with decreased red blood cell life span (RBCLS) being a significant contributor. Although the impact of reduced RBCLS on anemia is recognized, it is still a subject that is not well researched. The objective of this study was to investigate the relationship between RBCLS and inflammatory biomarkers in chronic HD patients.
DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: RBCLS was calculated from alveolar carbon monoxide concentrations measured by gas chromatography. Interleukins (IL) IL-6, IL-18, IL-10, and high sensitivity C-reactive protein were measured using bead-based multiplex assay. Measurements were carried out at baseline and during follow-up. The associations between RBCLS and inflammatory biomarkers were evaluated using linear mixed effects models.
RBCLS measurements were available for 54 HD patients. Their average age was 58.5 ± 14.4 years, 68.5% were males, 48.1% were diabetics, and the HD vintage was 51 ± 48 months. In 4 patients, RBCLS was measured once, while in 50 patients, up to 5 repeated RBCLS measurements were available. RBCLS was 73.2 ± 17.8 days (range 37.7-115.8 days). No association was found between RBCLS and any of the inflammatory biomarkers. Of note, RBCLS was positively correlated with levels of uric acid (p = 0.02) and blood urea nitrogen (BUN; p = 0.01), respectively.
Our study suggests that inflammation pathways reported by these biomarkers only have a limited role in causing premature RBC death. The positive correlation with uric acid and BUN warrants further studies.
血液透析（HD）患者贫血的发病机制取决于多种因素，其中红细胞寿命缩短（RBCLS）是一个重要因素。尽管RBCLS缩短对贫血的影响已得到认可，但仍是一个研究不足的课题。本研究的目的是探讨慢性HD患者RBCLS与炎症生物标志物之间的关系。
设计、地点、参与者及测量方法：通过气相色谱法测量肺泡一氧化碳浓度来计算RBCLS。使用基于微珠的多重检测法测量白细胞介素（IL）IL-6、IL-18、IL-10和高敏C反应蛋白。在基线和随访期间进行测量。使用线性混合效应模型评估RBCLS与炎症生物标志物之间的关联。
54例HD患者有RBCLS测量值。他们的平均年龄为58.5±14.4岁，68.5%为男性，48.1%为糖尿病患者，HD病程为51±48个月。4例患者进行了1次RBCLS测量，50例患者有多达5次重复的RBCLS测量值。RBCLS为73.2±17.8天（范围37.7 - 115.8天）。未发现RBCLS与任何炎症生物标志物之间存在关联。值得注意的是，RBCLS分别与尿酸水平（p = 0.02）和血尿素氮（BUN；p = 0.01）呈正相关。
我们的研究表明，这些生物标志物所报告的炎症途径在导致红细胞过早死亡方面仅起有限作用。与尿酸和BUN的正相关值得进一步研究。
