IMPAIRED BACTERIAL KILLING AND HYDROGEN-PEROXIDE PRODUCTION BY POLYMORPHONUCLEAR NEUTROPHILS IN END-STAGE RENAL-FAILURE

Polymorphonuclear leukocytes (PMN) isolated from a sub-population of p atients with end-stage renal failure (ESRF) who were identified becaus e they demonstrated impaired intracellular bacterial killing, were ass ayed for hydrogen peroxide activity using two different techniques cap able of distinguishing between total and intracellular hydrogen peroxi de generation. In an attempt to elucidate the mechanism of impaired in tracellular bacterial killing further, hydrogen peroxide activity was compared to PMN isolated from patients receiving continuous ambulatory peritoneal dialysis and a control group of healthy normal volunteers, PMN from conservatively treated ESRF patients demonstrated reduced pr oduction of intracellular hydrogen peroxide (mean 37.7 +/- 4.3 fluores cence units), compared to PMN from both ESRF patients treated with con tinuous ambulatory peritoneal dialysis (mean 57.9 +/- 6.6 fluorescence units) and normal controls (mean 60.4 +/- 3.5 fluorescence units), Th is suggests that the probable mechanism of impaired bacterial intracel lular killing by the PMN of conservatively treated ESRF patients invol ves the production of intracellular hydrogen peroxide.