Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Lemesch, S; Ribitsch, W; Schilcher, G; Spindelböck, W; Hafner-Gießauf, H; Marsche, G; Pasterk, L; Payerl, D; Schmerböck, B; Tawdrous, M; Rosenkranz, AR; Stiegler, P; Kager, G; Hallström, S; Oettl, K; Eberhard, K; Horvath, A; Leber, B; Stadlbauer, V.
Mode of renal replacement therapy determines endotoxemia and neutrophil dysfunction in chronic kidney disease.
Sci Rep. 2016; 6(6):34534-34534
Doi: 10.1038/srep34534
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- Leading authors Med Uni Graz
- Lemesch Sandra
- Ribitsch Werner
- Co-authors Med Uni Graz
- Eberhard Katharina
- Hafner-Giessauf Hildegard Elisabeth
- Hallström Seth
- Horvath Angela
- Kager Gerd
- Leber Bettina
- Marsche Gunther
- Öttl Karl
- Pasterk Lisa
- Payerl Doris
- Rosenkranz Alexander
- Schilcher Gernot
- Spindelböck Walter Johann
- Stadlbauer-Köllner Vanessa
- Stiegler Philipp
- Tawdrous Monika
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- Abstract:
- Bacterial infection and sepsis are common complications of chronic kidney disease (CKD). A vicious cycle of increased gut permeability, endotoxemia, inadequate activation of the innate immune system and resulting innate immune dysfunction is hypothesized. We assessed endotoxemia, neutrophil function and its relation to oxidative stress, inflammation and gut permeability in patients with CKD grade 3-5 without renal replacement therapy (CKD group, n = 57), patients with CKD stage 5 undergoing haemodialysis (HD, n = 32) or peritoneal dialysis (PD, n = 28) and patients after kidney transplantation (KT, n = 67) in a cross-sectional observational study. In HD patients, endotoxin serum levels were elevated and neutrophil phagocytic capacity was decreased compared to all other groups. Patients on HD had a significantly higher mortality, due to infections during follow up, compared to PD (p = 0.022). Oxidative stress, neutrophil energy charge, systemic inflammation and gut permeability could not completely explain these differences. Our findings suggest that dialysis modality and not renal function per se determine the development of neutrophil dysfunction and endotoxemia in CKD-patients. HD patients are particularly prone to neutrophil dysfunction and endotoxemia whereas neutrophil function seems to improve after KT. Multi-target approaches are therefore warranted to improve neutrophil function and potentially reduce the rate of infections with patients undergoing haemodialysis.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Aged -
- Aged, 80 and over -
- Bacterial Infections - blood
- Bacterial Infections - etiology
- Bacterial Infections - mortality
- Bacterial Infections - therapy
- Cross-Sectional Studies -
- Endotoxemia - blood
- Endotoxemia - etiology
- Endotoxemia - mortality
- Endotoxemia - pathology
- Female -
- Humans -
- Male -
- Middle Aged -
- Neutrophils - metabolism
- Neutrophils - pathology
- Oxidative Stress -
- Renal Insufficiency, Chronic - blood
- Renal Insufficiency, Chronic - mortality
- Renal Insufficiency, Chronic - therapy
- Renal Replacement Therapy -