GRANULOCYTE STIMULATING FACTOR IN PATIENTS ON PERITONEAL-DIALYSIS ANDLPS STIMULATED PERIPHERAL-BLOOD MONONUCLEAR-CELLS

Dialysate and serum levels of granulocyte-colony stimulating factor (G -CSF), granulocyte macrophage colony stimulating factor (GM-CSF) and l eukemia inhibitory factor (LIF) were analyzed in patients with continu ous ambulatory peritoneal dialysis (CAPD). Samples from the peritoneal effluent and from serum were obtained during the first months of dial ysis and during peritonitis from the first three dialysate bags draine d on the day of admittance and from nightbags on days three and ten. S erum samples were drawn on days one and ten. On the first day of infec tion G-CSF was detected in twelve out of fifteen samples in the dialys ate and reached its peak median level, 443 pg/ml, in the first drained bag and thereafter decreased significantly. Also in serum a peak, 190 pg/ml, was observed on the first day. LIF was found in six of ten ana lyzed dialysate samples, with a peak median level of 77 pg/ml on day o ne, while only four of ten patients had detectable GM-CSF. Peripheral blood mononuclear cells from non-infected CAPD patients were stimulate d with lipopolysacharide and G-CSF levels in the supernatants increase d significantly (P < 0.05) after 6 h stimulation. We conclude that G-C SF is produced locally in the dialysate during the acute stage of peri tonitis and to a lesser extent also systemically. These findings are i n line with G-CSF production after LPS stimulation of peripheral blood mononuclear cells.