Microinflammation induces endothelial damage in hemodialysis patients: the role of convective transport

Cardiovascular complications are a major cause of mortality in hemodialysis patients. On-line hemofiltration combines convective clearance for removing large solutes with diffusion to remove small solutes and is associated with a significant reduction of inflammation and improved patient survival. W...

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Bibliographic Details
Published in:Kidney international Vol. 72; no. 1; pp. 108 - 113
Main Authors: Ramirez, R., Carracedo, J., Merino, A., Nogueras, S., Alvarez-Lara, M.A., Rodríguez, M., Martin-Malo, A., Tetta, C., Aljama, P.
Format: Journal Article
Language:English
Published: New York, NY Elsevier Inc 01.07.2007
Nature Publishing
Elsevier Limited
Subjects:
Adult
Aged
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Annexin A5 - metabolism
Biological and medical sciences
Cardiovascular Diseases - etiology
Cardiovascular Diseases - pathology
Cardiovascular Diseases - physiopathology
Cells, Cultured
Chronic Disease
circulating endothelial progenitor cells
Emergency and intensive care: renal failure. Dialysis management
endothelial microparticles
Endothelium, Vascular - pathology
Endothelium, Vascular - physiopathology
Female
Hemofiltration - methods
Humans
inflammation
Inflammation - pathology
Inflammation - physiopathology
Intensive care medicine
Kidney Diseases - complications
Kidney Diseases - physiopathology
Kidney Diseases - therapy
Lipopolysaccharide Receptors - blood
Male
Medical sciences
Middle Aged
Nephrology. Urinary tract diseases
on-line hemodiafiltration
Platelet Endothelial Cell Adhesion Molecule-1 - metabolism
Receptors, IgG - blood
Renal Dialysis - methods
Stem Cells - metabolism
Stem Cells - pathology
vascular damage
vascular reparation
endothelial microparticles
on-line hemodiafiltration
vascular damage
inflammation
vascular reparation
circulating endothelial progenitor cells
Human
Endothelial cell
Nephrology
Hemodialysis
Stem cell
Inflammation
Urology
Extrarenal dialysis
Hemodiafiltration
Blood vessel
Microparticle
Circulatory system
Lesion
Transport
Progenitor cell
ISSN:0085-2538, 1523-1755
Online Access:Get full text
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Summary:Cardiovascular complications are a major cause of mortality in hemodialysis patients. On-line hemofiltration combines convective clearance for removing large solutes with diffusion to remove small solutes and is associated with a significant reduction of inflammation and improved patient survival. We compared on-line hemofiltration to high-flux hemodialysis (HF-HD) in patients in a sequential manner. At baseline, 15 stable patients on HF-HD as compared with five control subjects showed significant increases in CD14+CD16+ cells, endothelial microparticles, and endothelial progenitor cells (EPCs). After 4 months of on-line hemofiltration, the number of CD14+CD16+ cells, microparticles, and EPCs decreased. After returning to HF-HD for 4 months, all measured parameters returned to their respective baseline values. The number of CD14+CD16+ cells correlated with both endothelial microparticles and EPCs. We conclude that on-line hemofiltration attenuates endothelial dysfunction possibly by decreasing microinflammation. This effect may be directly caused by a modulatory effect of on-line hemofiltration on proinflammatory cells or by a complex interaction that encompasses a wider removal of uremic toxins.
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ISSN:0085-2538
1523-1755
DOI:10.1038/sj.ki.5002250