INTERLEUKIN-8 IN CHRONIC-RENAL-FAILURE AND DIALYSIS PATIENTS

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.