Abstract
We measured tumor necrosis factor (TNFα), interleukin-1 (IL1-B), and beta-2 microglobulin (B2M) levels in 10 chronic hemodialysis patients before and during dialysis with six different dialysate/dialyzer combinations. The mean pre-dialysis serum level of B2M was 23.4 ± 11.1 mg/L (nl < 3 mg/L). There was no significant effect of hemodialysis with any dialysate/dialyzer combination on intradialytic serum B2M levels. Five patients had detectable pre-dialysis serum levels of TNFα (>40 pg/ml) at least once and 2 had detectable levels prior to all dialyses. Six patients had detectable pre-dialysis serum levels of IL1-B (>20 pg/ml) at least once, and 2 had detectable levels prior to all dialyses. Serum TNFα, IL1-B and B2M levels were not significantly correlated with one another. Our data do not support the hypothesis that blood-membrane interactions significantly affect circulating levels of TNFα, IL1-B or B2M. Chronic high level elevations of plasma IL1-B and TNFα are not uniformly observed in hemodialysis patients, arguing against a role for these substances as systemic uremic toxins.
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