SOLUBLE INTERLEUKIN-2 RECEPTOR IN DIALYZED PATIENTS

Azotemic patients are usually characterized by a state of so-called pr eactivation resulting in excessive expression of interleukin 2 recepto rs (IL-2R) on T lymphocytes. The etiological mechanism of this preacti vation is, however, still speculative. We studied the serum level of t he soluble form of IL-2R (sIL-2R) in azotemic patients on either hemod ialysis (HD) (n = 49) or continuous ambulatory peritoneal dialysis (CA PD) (n = 45), Both patient groups had significantly higher sIL-2R leve ls (1,750 +/- 664 U/ml in the HD group and 1,769 +/- 647 U/ml in the C APD group, respectively) p < 0.00001 as compared to the normal control group (511 +/- 436 U/ml). However, there was no significant differenc e between the levels of the HD and CAPD group patients. When clinical parameters were studied for their influence on sIL-2R levels, none of the following caused any significant changes: blood transfusion, type of dialyzer used, type of dialysis fluid used, treatment with erythrop oietin, hepatitis B infection, or liver function profile. We conclude that chronic renal failure per se is the major cause of the preactivat ion of T lymphocytes. The modes of treatment and various clinical vari ables in these patients have no significant influence on sIL-2R levels .