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Kidney Week

Abstract: FR-PO490

Effect of Different Dialysis Procedures on Monocyte Subsets

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Krieter, Detlef H., University Hospital Würzburg, Würzburg, Germany
  • Merget, Karin, eXcorLab GmbH, Obernburg, Germany
  • Rueth, Marieke, eXcorLab GmbH, Obernburg, Germany
  • Lemke, Horst-Dieter, eXcorLab GmbH, Obernburg, Germany
  • Wanner, Christoph, University Hospital Würzburg, Würzburg, Germany
Background

In cardiovascular and end-stage kidney disease, monocyte subsets are associated with cardiovascular events and mortality. The aim of the present study was to monitor monocyte subsets over a 6-week period in individuals on different extracorporeal dialysis procedures.

Methods

In a prospective, randomized, controlled, cross-over study enrolling 15 maintenance dialysis patients (DRKS00010788), low-flux and high-flux hemodialysis (HD) were compared to high convective volume (≥25 L) postdilution hemodiafiltration (HDF). Each patient was subjected thrice weekly to each treatment mode for 6 consecutive weeks. Dialysis membrane material was always identical (PUREMA® L and H, resp.). Dialysate flow rates differed in HD and HDF (500 vs. 700 mL/min). Blood flow rates and treatment time were kept identical for individual patients. Monocyte subsets were determined at baseline (t0), after 3 (t3) and 6 weeks (t6) of each treatment period. Monocytes subtypes were differentiated in classical (CD14++/CD16-), intermediate (CD14++/CD16+) and non-classical (CD14+/CD16++) by flow-cytometric analysis. In addition, highly sensitive serum CRP was monitored by ELISA.

Results

While there were no differences in monocyte subsets over time within and between treatment modes, ANOVA revealed a lower number of total monocytes at t6 in HDF compared to low-flux HD (885±245 vs. 993±349 cells/µl; P=0.019). Classical monocytes ranged between 677±191 (high-flux HD, t3) and 763±297 (low-flux HD, t6) cells/µl, intermediate monocytes between 91±31 (HDF, t3) and 125±89 (HDF, t0) cells/µl, and non-classical monocytes between 83±39 (HDF, t3) and 109±54 (low-flux HD, t3) cells/µl. Furthermore, no differences in CRP levels were found within and between treatments (range 5.12±7.18 mg/L in HDF at t6, and 11.42±19.17 mg/L in low-flux HD at t6). CRP correlated with total monocytes (r=0.638, P<0.001) as well as with classical (0.608, P<0.001), non-classical (0.216, P=0.017) and intermediate (0.520, P<0.001) subtypes.

Conclusion

Over a 6-week period, large differences in toxin removal of extracorporeal dialysis therapies have no impact on monocyte subsets and inflammation. Monocyte phenotypes may be useful to characterize inflammation in patients on maintenance dialysis.

Funding

  • Commercial Support