A total of 105 patients participated in this study, including 10 with
chronic glomerulonephritis with normal renal function (CGN patients),
36 uraemic patients (CRF patients), 19 continuous ambulatory peritonea
l dialysis patients (CAPD) without peritonitis, three CAPD patients wi
th peritonitis, 37 patients undergoing chronic haemodialysis (HD) divi
ded into short-term HD, 15 patients; medium-term HD, 12 patients; and
long-term HD, 10 patients. IL-8 and two other proinflammatory cytokine
s, IL-6 and TNFalpha were tested using a specific immunoassay. IL-8, I
L-6, and TNFalpha serum levels were significantly increased in patient
s with chronic renal failure compared to their levels in normal indivi
duals (P<0.0001, P<0.05 and P<0.0001 respectively). The most pronounce
d increment in IL-8, IL-6 and TNFalpha serum levels was observed in CA
PD patients (P<0.0001). CAPD patients without peritonitis showed relat
ively low levels of IL-8 or IL-6 in peritoneal dialysate effluents (PD
E), whereas PDE-TNFalpha were not detectable in almost all patients te
sted. Patients with peritonitis showed very high serum and PDE levels
of IL-8, IL-6 and TNFalpha. The clinical recovery from peritonitis was
characterized by a rapid fall in IL-8, IL-6 and TNFalpha in serum and
dialysate. HD patients showed a significant increase in serum levels
of IL-8 and also IL-6 and TNFalpha compared to normal individuals (P<0
.05, P<0.05 and P<0.01 respectively). HD duration influenced serum lev
els of IL-8 and TNFalpha since they were significantly higher in short
-term HD patients than medium- or long-term HD patients (respectively
P<0.05, P<0.001 for IL-8, and P<0.01, P<0.001 for TNFalpha). Pre-HD IL
-6 levels were not influenced by HD duration. No major modification of
IL-8 serum levels could be evinced after and before HD sessions in th
e short-term group, but concentrations of this cytokine were significa
ntly higher after HD in medium- and long-term HD patients (P<0.05, P<0
.01 respectively). In contrast, HD session did not influence IL-6 and
TNFalpha levels. We conclude that the cytokine profile is perturbed in
ureaemia and during dialysis, and that this should be considered as a
n inflammatory status.