GRANULOCYTE-MONOCYTE COLONY-STIMULATING FACTOR LEVELS DURING HEMODIALYSIS-INDUCED LEUKOPENIA

Hemodialysis (HD), especially with cellulosic membranes, leads regular ly to a transient but marked drop of peripheral neutrophils. Such neut ropenia during the initial 10-30 min of HD is followed by a reincrease in granulocyte count up to a mild leukocytosis. Although this phenome non accounts for the best documented side effect of HD, little is know n about the underlying regulatory mechanisms. Therefore in this study the blood levels of granulocyte-macrophage colony-stimulating factor ( GM-CSF) were measured during HD. Previous investigations have demonstr ated that GM-CSF plays the central role in controlling the homeoiostas is of leukocytes by up- and downregulation of proliferation and efflux of cells out of the maturation compartment within the bone marrow. Th ree patients with chronic renal failure underwent HD with cuprophane m embranes. In all cases a significant drop of peripheral granulocytes o ccurred, but GM-CSF levels remained unchanged and were found in the no rmal range during the whole period of the treatment. It is therefore c oncluded that GM-CSF may not be significantly involved in the regulati on of peripheral leukocytes during HD.