Suárez R, Souto R, Navillat M, Galegari M, Hernández J

Language: Spanish
References: 12
Page: 154-158
PDF size: 77.11 Kb.

ABSTRACT

Thirty percent of patients with renal failure during chronic hemodialysis present arthropathies. The etiopathogenicity of these clinical cases is still being argued. To ascertain whether inflammatory cytokines play a role in the development of this disease, we studied a group of 119 dialyzed patients of both sexes, with average seniority, having been dialyzed for 48 months. A radiological, clinical, and transversal study was carried out in this population, establishing the following two groups: group A with clinical manifestations (intra-or post-dialysis arthralgias, carpal tunnel syndrome, erosive radiological signs, etc.), and group B, with no clinical manifestations or radiological articulars. We measured serie levels of interleukin 1 (IL1) and tumor necrosis factor (TNF) interleukins by ELISA and reactive C protein (RCP) by turbidimetry in both group. Significant differences (p = 0.0001) for IL1, TNF, and RCP were obtained in both groups, with a correlation index of 0.95. The group with articular manifestations showed higher levels of interleukins and RCP (means: IL1 34.3 mg/dL, TNF 36.4 mg/dL, and RCP 14.7 mg/dL) with respect to the group without articular manfestations (means: IL1 13.1 pg/mL, TNF 17.3 pg/mL, and RCP 4.7 mg/dL). Because IL1 has greater lesion-produccing activity on cartilage and bone, the IL1/TNF index was carried out in both groups. Significant differences were found (means of group A 0.94, means of group B 0.76), that is, greater relative IL1 activity was observed in the group with clinical manifestations. We propose that there exists relative IL1 hyperactivity with respect to TNF. This could lie in the pathogenic base of articular manifestations during chronic hemodialysis. IL1 mechanisms of relative and absolute elevation with respect to TNF during the hemodialysis period are argued.

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