Vascular Access for Hemodialysis and Inflammation
Conditions
Keywords
AVF, AVG, TCC, inflammation, monocite senescence
Brief summary
The aim of the present study was to investigate patients free of active infection and/or thrombosis to assess if the type of vascular access (AVF, AVG, TCC), could influence: 1. the levels of serological markers of inflammation (CRP, IL-6, TNF-a); 2. the degree of expression on monocyte surface of inflammation and immune response modulating molecules: CD14, CD32 and CD44. 3. the amount of monocytic cells expressing a senescent phenotype (CD14 and CD32).
Detailed description
Patients with AVF assumed ticlopidine 250 mg/die, patients with TCC and AVG assumed warfarin to maintain target INR between 1.8 and 2.5. Six wash out consecutive sessions were carried out before starting the study with Fresenius FX8 Helyxone® , for patients who underwent HD, or with FX 80 Helyxone®, for patients who underwent hemodiafiltration (HDF). After the wash out period, fresh whole blood and serum samples were drawn on starting dialysis, during the midweek HD session for 4 consecutive weeks. For each patient the mean value of the 4 blood samples was considered. All patients continued HD or HDF with FX8 or FX 80 Helyxone® during the whole study period.In order to estimate the normal ranges of the parameters that we evaluated, 60 anonymous healthy volunteers were also submitted to the same assays.
Interventions
None listed
Sponsors
IRCCS Azienda Ospedaliero-Universitaria di Bologna
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 85 Years
Healthy volunteers
Yes
Inclusion criteria
* All the patients recruited for the study were infection and thrombosis free from almost 6 months. * No patients included had autoimmune disease, hepatic failure, diabetes or malignancy. * Patients were not administered ACE inhibitors, angiotensin receptor antagonists, antiinflammatory or immunosuppressive drugs. * All the patients had residual GFR \< 5 ml/min. * The vascular access considered were placed from at least 6 months.
Exclusion criteria
* Patients with recirculating vascular access \> 10% were excluded from the study. * Patients with acute cardiovascular accident in the last 15 days before starting the study.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| serological markers of inflammation (CRP, IL-6, TNF-a) | 6 weeks |
| monocyte surface of inflammation and immune response modulating molecules: CD14, CD32 and CD44. | 6 weeks |
| monocytic cells expressing a senescent phenotype (CD14 and CD32). | 6 weeks |
Countries
Italy
Outcome results
None listed