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Abstract: PO1119

Effect of Dialysate Potassium on Interleukin 6 During Hemodialysis in Patients with ESRD

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Aggarwal (Gupta), Monika, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia, United States
  • Feldman, George M., Hunter Holmes McGuire VA Medical Center, Richmond, Virginia, United States
  • Samuel, Naveen, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia, United States
  • Bandyopadhyay, Dipankar, Virginia Commonwealth University, Richmond, Virginia, United States
  • Retnam, Reuben P., Virginia Commonwealth University, Richmond, Virginia, United States
  • Ghosh, Shobha, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia, United States
Background

Chronic inflammation is associated with poor outcomes in end stage renal disease (ESRD). Pro-inflammatory markers including interleukin-6 (IL-6) increase during hemodialysis . Efflux of intracellular potassium in cell cultures result in activation of inflammasome and release of inflammatory markers.We studied the effect of potassium efflux during hemodialysis on serum IL-6 .

Methods

15 patients with ESRD on chronic maintenance hemodialysis at Hunter Holmes McGuire VAMC were enrolled.Each subject participated in both interventions separated by at least two weeks.Intervention A involved 2K dialysate for the 1st hour followed by 4K for the second hour.Intervention B involved 4K for the 1st hour followed by 2K for the second hour. After first two hours, dialysate potassium was switched to the prescribed concentration for the remaining time Blood was drawn at 0,30,60,90,120,180, and 240 minutes after start of dialysis. Serum IL-6 was measured using ELISA. Data were analyzed using Mixed linear model with p<0.05 considered significant.

Results

IL-6 was detectable at baseline and increased during dialysis. However,mean levels of IL-6 were parallel between the 2 interventions (Figure 1.), implying no change in the rate of IL-6 production over time between the 2 interventions (Table 1.)

Conclusion

IL-6 increases during hemodialysis but rate of increase is not affected by dialysate potassium.

Table 1.Linear Mixed Model Serum IL-6
VariableEstimates95% CIP value
Intercept6.29971.3569-11.24240.012
Intervention B-0.6730-2.9578-1.61180.564
Time0.00790.0046-0.0112<0.001
Intervention B*Time0.0005-0.0041-0.00520.822

Figure 1.Serum IL-6 at different timepoints between 2 Interventions(Mean+SE)

Funding

  • Veterans Affairs Support