Dynamics of humoral antiendotoxin immunity parameters and the level of С-reactive protein in patients with chronic kidney disease who are treated by to the program hemodialysis for the four-year supervision

This work is devoted to the role of systemic chronic inflammation in the development of cardiovascular diseases which are the main cause of death of dialysis patients. We were also interesting in the contribution of bacterial endotoxin to the development of system chronic inflammation, as well as neutralizing effect of the antiendotoxin immunity on it. The purpose of this study was to investigate the dynamics of the antiendotoxin immunity indicators and the level of the C-reactive protein in patients with chronic kidney disease on the program hemodialysis. In 2007, 46 patients with chronic kidney disease on program hemodialysis were inspected. Only 32 of them were inspected again in 2011. Also the antiendotoxin immunity indicators and the C-reactive protein level were analyzed in 7 died patients within the first year just after the start of the study. Levels of serum antiendotoxin antibodies of classes A, M and G and the blood concentration of the C-reactive protein were determined by the method of solid-phase enzyme immunoassay. In patients with the chronic kidney disease on program hemodialysis whose treatment is continued currently, the high level of antiendotoxin IgG in blood was noted. In addition, these patients demonstrated an increase in the concentration of C-reactive protein, its level has increased a factor of 4,6 times (p < 0,001) for four years. We found a decrease in the level of serum antiendotoxin IgG and IgM and an increase in the concentration of the C-reactive protein in the patients who died during the first year of the observation. Such manifestations can be regarded as death predictors.

chronic kidney disease, hemodialysis, complications, systemic inflammation, endotoxin, antiendotoxin immunity, C-reactive protein, хроническая болезнь почек, гемодиализ, осложнения, системное воспаление, эндотоксин, антиэндотоксиновый иммунитет, С-реактивный белок

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