FlashMed

Abstract

Purpose: In an attempt to better understand the relationship between vascular
access and inflammation we assessed the effect of vascular access on
inflammatory markers changes during hemodialysis (HD) session.

Methods: Fifty HD patients were included: 23 patients with central venous
catheters (CVC) and 27 patients with arteriovenous fistulas (AVF). Blood
samples for high sensitivity C-reactive protein (hsCRP), Interleukin 6 (IL-6),
and Tumor Necrosis Factor α (TNF α) were collected before and after HD session. The outcome was the change
in the inflammatory markers during the dialysis.

Results: Predialysis hsCRP levels were high in 70% of patients, without
differences between the groups. Predialysis values were also similar in the two
groups for IL-6 and TNF α. There was no increase in hsCRP values following HD
and no difference between the change from baseline values in the CVC and AVF
groups (-0.01±0.09 mg/dL and -0.01±0.13 mg/dL, respectively [P=.95]).
IL-6 values increased during the HD session in the AVF group and
non-significantly decreased in the CVC group. The change from baseline values
was statistically significantly greater in the AVF group compared to the CVC
group (0.76±1.44 ng/mL and -0.52±1.66 ng/mL, respectively, P=.006). TNF α values were significantly decreased in the CVC group and were not changed
in the AVF group. The decrease from baseline values was not different between
the groups Conclusions: Chronic inflammation is present in most HD
patients. No increase in pro-inflammatory parameters was seen after a HD
session in patients treated via CVC or AVF.