EFFECT OF RENAL REPLACEMENT THERAPY ON CELLULAR CYTOKINE PRODUCTION IN PATIENTS WITH RENAL-DISEASE

To evaluate the effect of renal replacement therapy on cellular cytokine production in patients with renal disease, we studied interleukin 1 (IL-1) and interleukin-2 (IL-2) production by target cells stimulated with supernatants from cultured peripheral blood mononuclear cells from patients with end-stage renal disease, who were treated with hemodialysis and continuous ambulatory peritoneal dialysis (CAPD) before and after hemodialysis or a peritoneal dialysate exchange, compared to normal subjects used as time controls, and patients with chronic renal insufficiency. Initial cellular IL-2 production was increased in patients with hemodialysis, compared to normal controls. The ratio of pretreatment cellular IL-2 and IL-1 production was increased in all patient groups compared to normal subjects. Both hemodialysis and CAPD treatments resulted in increased cellular IL-1 (51.7%, P < 0.007, and 42.8%, P < 0.002, respectively) and IL-2 production (50.5% P < 0.015, and 33.3%, P < 0.0008, respectively). The hemodialysis group had significantly higher cellular IL-2 production compared with normal controls' after treatment. After treatment, the IL-2/IL-1 ratio remained elevated in all groups with renal disease compared with normal subjects. We conclude patients with renal disease have an abnormal functional relationship between IL-1 and IL-2, characterized by increased IL-2 production per level of IL-1, unaffected by type or presence of renal replacement therapy.