Longitudinal Study of Apoptosis in Chronic Uremic Patients

Vincenzo D'Intini, Valeria Bordoni, Antonio Fortunato, Elisabetta Galloni, Mariarita Carta, Francesco Galli, Irene Bolgan, Paola Inguaggiato, Sonya Poulin, Monica Bonello, Ciro Tetta, Nathan Levin, Claudio Ronco

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

Uremia is associated with a state of immune dysfunction, increasing infection and malignancy rates. Dysregulation of homeostasis may be directly related to abnormal apoptosis regulation, a process which is crucial for the maintenance of the biologic system. Abnormal apoptosis rates (ARs) have been reported in the literature. We performed a longitudinal study over a 10-week period in three groups of uremic subjects - hemodialysis (HD), peritoneal dialysis (PD), and predialysis chronic renal failure (CRF). Our results showed that ARs were consistent over the observed period. Monocytes extracted from HD and CRF subjects had higher ARs compared to PD and controls (HD: 26.06 ± 8.82; CRF: 26.96 ± 12.81; PD: 14.77 ± 5.87; C: 11.42 ± 4.60) when placed in culture medium. The plasma of HD and CRF subjects when incubated with U937 cells had a stronger apoptogenic potential compared with PD and controls (HD: 26.08 ± 11.39; CRF: 24.87 ± 9.07; PD: 12.13 ± 4.51; C: 11.69 ± 4.02). Inflammatory markers (C-reactive protein [CRP], procalcitonin) and cytokines (interleukin [IL]-β, IL-2, IL-10) had a generally poor correlation except for tumor necrosis factor (TNF)-α (p < 0.001). The phagocytic ability of U937 cells when incubated with the various plasma demonstrated impaired response in the HD and CRF subjects (HD: 27.56 ± 6.67; CRF: 30.24 ± 9.08; PD: 36.55 ± 9.80; C: 40.04 ± 6.98). These results suggest continuous renal purification, such as in continuous ambulatory peritoneal dialysis (CAPD), may have advantages over intermittent therapies in regulating apoptosis and maintaining biologic function and homeostasis.

Original languageEnglish
Pages (from-to)467-473
Number of pages7
JournalSeminars in Dialysis
Volume16
Issue number6
DOIs
StatePublished - Nov 2003
Externally publishedYes

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