Blood–membrane interaction in hemodialysis leads to increased cytokine production

Abstract

Blood–membrane interaction in hemodialysis leads to increased cytokine production. Recently much interest has been focused on the role of immunoregulatory cytokines such as interleukin 1 (IL 1) and interleukin 2 (IL 2) during the pathogenesis of immunological as well as inflammatory diseases. Therefore peripheral blood mononuclear cells (PBMC) of eight patients undergoing hemodialysis (HD) were tested for IL 1 and IL 2 production. Before starting HD, cytokine production by PBMC in culture was not altered in comparison to normal healthy controls, however, a significant increase of IL 1 and IL 2 production was observed within the first HD hour which lasted throughout the end of HD. Moreover direct effects of cellulose membranes on PBMC cytokine production as well as serum IL 1 levels have been investigated. Serum IL 1 levels were already elevated before onset of HD and increased further during HD. The discrepancy between PBMC IL 1 production and serum IL 1 levels may be due to the diminished excretion in patients with end-stage renal disease. Since addition of dialysis membrane particles enhanced monocytes to produce more IL 1 as well as lymphocytes to release more IL 2, a direct stimulatory membrane effect is postulated. The increased release of immunoregulatory cytokines may account for some of the pathologic findings observed during hemodialysis