A Research Of The Changes Of Microimflammatory State Related-factors In Maintenance Hemodialysis Patients

Objective: We investigate the concentration changes of plasma C-reactive protein(CRP),interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α) and Von Willebrand Factor (VWF) in different time segments of hemodialysis (HD) procedures among maintenance hemodialysis(MHD) patients . To learn the change trends of microimflammatory related- factors ; to explore if the microimflammatory state and the injury of vascular endothelia cell (VEC) exist in MHD; also to explore the relationships among plasma albumin(ALB),imflammation and vascular injuries. Methods: 20 chronic renal failure (CRF) patients who are in MHD with the first using of polysolfone (PS) were selected as HD group and 20 health persons were selected as control group. In HD group, the procedure of HD was divided into 8 time segments:before HD ,after 1/2-hour HD ,after 1-hour HD, after 3-hour HD, after 4.5 to 5-hour HD, after 12-hour HD, after 24-hour HD and after 48-hour HD. The plasma CRP,VWF concentration were determined with immunoturbidimetric method. The plasma IL-1βand TNF-αconcentration were determined with enzyme-linked immunosorbant assays techique (ELISA). In the same time, we measured the concentrations of serum ALB , total cholesterol(TC), glyceraldehyde 3-phosphote(TG), low-density lipopreteins(LDL) .Results: ①The plasma CRP levels of all the 8 time segments were increased significantly in HD group compared with health control group (P<0.05) and appeared a rising trend after 1-hour HD and it reached its top point after 12-hour HD end . It decreased gradually and went back to pre-dialysis levels at 48 hours after HD end . .②. It was before HD, after 1/2-hour HD and HD end that the plasma concentration of IL-1βand TNF-αwere increased significantly in HD group compared with control group (P<0.05) and they were not different among the 3 time segments in HD group (P>0.05). ③The plasma concentration of TNF-αafter 4.5 to 5-hour HD were positive interrelation with the plasma concentration of after 12-hour HD end(r=0.69). Before HD,plasma concentration of CRP were negative interrelation with ALB(r=-0.48) and positive interrelation with LDL(r=0.49). ④The plasma VWF levels of all the 8 time segments were increased significantly in HD group compared with health control group (P<0.05) and appeared a rising trend during HD procedures. It was after 3-hour HD that it reached its top point and maintained to the end of HD. It was decreased gradually and went back to pre-dialysis levels at 48 hours after HD end. ⑤.Before HD,plasma concentration of VWF were negative interrelation with ALB . Before HD , after 1/2-hour HD andafter 4.5-5 hour HD ,VWF levels were all positive interrelation with IL-1β and TNF-α at the same time segments during HD(p<0.01). VWF had no interrelation with CRP at the same time segments during HD. Conclusions: ①. CRP, IL-1β,TNF-α all increase in MHD patients that MHD patients exist microimflammatory state . ②. VWF increase in MHD patients that MHD patients exist VEC injury.③CRP, VWF,IL-1β,TNF-α all increase during HD in MHD patients which increasing time and decreasing time are different to each other.④. Plasma CRP, IL-1β,TNF-α,TC, TG, LDL, ALB are related to each other in MHD patients.