Systemic inflammatory reaction in ESRD patients

Abstract

The goal of the study was to assess pathogenesis of the end stage renal disease (ESRD) from the point of view of systemic inflammation. Material and methods. 42 patients (age 45,4 ± 12,95 years) with ESRD caused by chronic glomerulonephritis (n = 22), chronic pyelonephritis (n = 12) and diabetic nephropathy (n = 8) were examined and compared to control group of 68 healthy subjects (18-84 years). All patients received program haemodialysis for 12 hours per week. Duration of the HD treatment was 63,0 ± 62,13 months (from 1 to 223 months). Before and after haemodialysis the blood plasma levels of IL-1b, IL-6, IL-8, IL-10, TNFa, CRP, ECP, myoglobin, troponin I, cortisol, D-dimers were measured, with immunochemiluminescent method (“Immulite”, SIMIENS, USA). Results. The following significant (p < 0,05) changes were found in the ESRD patients: hypercytokinemia (mainly due to TNFa and IL-8), accumulation of 2R, CRP, CRP, ECP, myoglobin, troponin I, cortisol, D-dimers in blood. The most informative factor was the integrated index for cytokinemia - RC, a scoring of 0 to 16 points calculated from the levels of IL-6, IL-8, TNFa. Conclusion. The systemic inflammation phenomenon plays a significant role in the ESRD pathogenesis. The intensity of the systemic inflammation can be estimated with the integrated index for cytokinemia.