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Inflammatory status in chronic renal failure: The role of homocysteinemia and pro-inflammatory cytokines

查看全文 作　　者：Hadja Fatima [1]Tbahriti;Djamel [2]Meknassi;Rachid [3]Moussaoui;Amar [3]Messaoudi;Lakhdar [4]Zemour;Abbou [2]Kaddous;Malika [1]Bouchenak;Khedidja [1]Mekki 高影响力作者 机构地区：[1]Laboratoire de Nutrition Clinique et Métabolique, Faculté des Sciences de la Nature et de la Vie, Université d’Oran, Oran 31100, Algérie;[2]Service de Néphrologie, Etablissement Hospitalier Universitaire (EHU) d’Oran, Oran 31037, Algérie;[3]Service de Biochimie, Etablissement Hospitalier Universitaire (EHU) d’Oran, Oran 31037, Algérie;[4]Service d’épidémiologie, Etablissement Hospitalier Universitaire (EHU) d’Oran 31037, Oran 31037, Algérie高影响力机构 出　　处：《World Journal of Nephrology》索引2013年第2卷第2期,共7页高影响力期刊 摘　　要：AIM: To evaluate determinants of inflammatory markers in chronic renal failure patients according to the level of glomerular filtration rate. METHODS: One hundred fifty four patients(Age; 44 ± 06 years, male/female; 66/88) with chronic renal failure(CRF) were divided into 6 groups according to the National Kidney Foundation(NKF) classification. They included 28 primary stage renal failure patients(CRF 1), 28 moderate stage renal failure patients(CRF 2),28 severe stage renal failure patients(CRF 3), 18 endstage renal failure patients(CRF 4), 40 hemodialysis(HD) patients, and 12 peritoneal dialysis(PD) patients. Tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), interleukin-6(IL-6) and C-reactive protein(CRP) were analyzed by immunosorbent assay kit(ELISA)(Cayman Chemical's ACETM EIA kit). Immunoassay methods were used for total homocysteine(tH cy)(fluorescence polarization immunoanalysis HPLC, Perkin Emer 200 series), transferrin(MININEPHTM human transferin kit: ZK070.R), ferritin(ADVIA Centaur) and fibrinogen analysis(ACL 200). Differences between groups were performed using SPSS 20.0 and data are expressed as the mean ± SD.RESULTS: Results showed that in comparison with CRF 1 group and other groups, TNF-α and IL-6 levels were respectively more elevated in HD(16.38 ± 5.52 pg/mL vs 0.39 ± 0.03 pg/mL, 11.05 ± 3.59 pg/mL vs 8.20 ± 0.22 pg/mL, P < 0.001) and PD(14.04 ± 3.40 pg/m L vs 0.39 ± 0.03 pg/m L, 10.15 ± 1.66 pg/m L vs 8.20 ± 0.22 pg/m L, P < 0.001). IL-1β levels were increased in HD(9.63 ± 3.50 pg/m L vs 3.24 ± 0.10 pg/mL, P < 0.001) and CRF 4(7.76 ± 0.66 pg/mL vs 3.24 ± 0.10 pg/m L, P < 0.001) patients than in CRF 1 and in the other groups. Plasma t Hcy levels were higher in HD(32.27 ± 12.08 μmol/L) and PD(28.37 ± 4.98 μmol/L) patients compared to the other groups of CRF(P < 0.001). The serum CRP level was significantly increased in HD(18.17 ± 6.38 mg/L) and PD(17.97 ± 4.85 mg/L) patients compared to the other groups of CRF patients(P < 0.001). The plasma fibrinogen level was more elevated in HD(6.86 ± 1.06 g/L) and CRF 4(6.05 ± 0.57 g/L) than in the other groups(P < 0.001). Furthermore; the ferritin level was higher in HD(169.90 ± 62.16 ng/m L) and PD(90.08 ± 22.09 ng/m L) patients compared to the other groups of CRF(P < 0.001). The serum transferrin value was significantly decreased especially in PD(1.78 ± 0.21 g/L) compared to the other groups(P < 0.001). We found a negative correlationbetween glomerular filtration rate(GFR), TNF-α levels(r =-0.75, P < 0.001), and t Hcy levels(r =-0.68, P < 0.001). We observed a positive correlation between GFR and transferrin levels(r = 0.60, P < 0.001). CONCLUSION: CRF was associated with elevated inflammatory markers. The inflammation was observed at the severe stage of CRF and increases with progression of renal failure. 关 键 词：肾小球 肾病 治疗方法 临床分析
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