Effect Of Hemodiafiltration On Gene Expression And Serum Levels Of IL-8,TNF-?,HMGB1 In Hemodialysis Patients

?Objective?To observe the effect of hemodiafiltration(HDF)treatment on the gene expression and serum levels of IL-8,TNF-?,and HMGB1 in hemodialysis patients.?Methods?According to the random number table method,20 patients with maintenance hemodialysis(MHD)who met the inclusion criteria in the Department of Blood Purification of the First Affiliated Hospital of Guangxi Medical University from October 2017 to November 2017 were selected as the case group,and another 15 healthy examinations were selected as a normal control group.The case group was treated with HDF.The Dialog+type HDF-online dialysis filtration machine was used.The dialyzer was Fresenius FX800,the polysulfone membrane material,the membrane area was 1.8m~2,and the ultrafiltration coefficient was 59ml/h�mmHg.The treatment time was 240minutes,the blood flow was 200-300 ml/min,the dialysate flow was 800 ml/min,the replacement fluid flow was 125-150 ml/min,and the replacement fluid was supplemented with the previous dilution.In all dialysis patients,autologous arteriovenous fistulas or long-term intracerebral catheters were used as vascular access.All patients were treated with unfractionated heparin or low molecular weight heparin anticoagulation.Serum levels of IL-8,TNF-?,HMGB1,and the mRNA expression level of neutrophils in the case group and healthy control group were detected by enzyme-linked immunosorbent assay(ELISA)and Quantitative Real-time PCR(qRT-PCR).By self-matching design,the mRNA expression and serum levels of IL-8,TNF-?,HMGB1 before and after HDF dialysis treatment was detected in the case group of 20 patients.The levels of creatinine(Cr),Urea nitrogen(BUN),calcium(Ca),phosphorus(P),and?2-microglobulin(?2-MG)were detected.The effects of HDF on gene expression,inflammatory factors,and substance of small and medium-sized molecules were observed.?Results?The IL-8 mRNA expression level of neutrophil in the case group before dialysis was significantly higher than that in the control group(P<0.05),but the mRNA expression levels of TNF-?and HMGB1 were not different from those in the control group(P>0.05).In the case group treated with HDF,the mRNA expression levels of IL-8,TNF-?,and HMGB1 in neutrophils after treatment were not significantly different from those before treatment.The difference was not statistically significant(P>0.05).The serum levels of IL-8,TNF-?and HMGB1 in the case group before dialysis were significantly higher than those in the control group(P<0.05).In the case group treated with HDF for 240 minutes,the serum levels of IL-8,TNF-?,and HMGB1 after treatment were significantly decreased compared with those before treatment.The difference was statistically significant(P<0.05).The levels of Cr,BUN,P,and?2-MG after HDF treatment were significantly lower than those before treatment(P<0.05).The level of Ca after treatment was not significantly different from that before treatment(P>0.05).?Conclusion?1.HDF treatment did not affect the gene expression of IL-8,TNF-?and HMGB1 in neutrophils of MHD patients;2.HDF treatment can effectively reduce the serum levels of IL-8,TNF-?,HMGB1 in MHD patients.