[Functions and metabolism of polynuclear neutrophils in patients under chronic hemodialysis].

Clinical evidence indicates that infection is still a cause of morbidity and mortality in patients undergoing hemodialysis. The major role played by the polymorphonuclear cells in antimicrobial response by the host explained considerable study of several aspects of granulocyte functions in chronic hemodialysis patients. It is now well documented that hemodialysis induces the sequential activation of the complement components of the alternative pathway and may provide a mechanism for initiating leukoaggregation and sequestration of granulocytes. This complement activation could also explain the profound leukopenia observed shortly after the initiation of hemodialysis. It has been also assumed that the sequestration of granulocytes is dependent on a temporarily altered cell function and leads to a depressed chemotaxis, an impairment of phagocytic and bactericidal capacities. Moreover, a significant defect in the oxidative metabolism was observed before and during the course of the dialysis session. This article summarizes research that has been done on the function of neutrophils from chronic hemodialysis patients.