A total of 105 patients participated in this study, including 10 with chronic glomerulonephritis with normal renal function (CGN patients), 36 uraemic patients (CRF patients), 19 continuous ambulatory peritoneal dialysis patients (CAPD) without peritonitis, three CAPD patients with peritonitis, 37 patients undergoing chronic haemodialysis (HD) divided into short-term HD, 15 patients; medium-term HD, 12 patients; and long-term HD, 10 patients. IL-8 and two other proinflammatory cytokines, IL-6 and TNF±were tested using a specific immunoassay. IL-8, IL-6, and TNFc serum levels were significantly increased in patients with chronic renal failure compared to their levels in normal individuals (P<0.000l, P<0.05 and P<0.000l respectively). The most pronounced incre ment in IL-8, IL-6 and TNF± serum levels was observed in CAPD patients (P<0.000l). CAPD patients without peritonitis showed relatively low levels of IL-8 or IL-6 in peritoneal dialysate effluents (PDE), whereas PDE-TNF± were not detectable in almost all patients tested. Patients with peritonitis showed very high serum and PDE levels of IL-8, IL-6 and TNFα. The clinical recovery from peritonitis was characterized by a rapid fall in IL-8, IL-6 and TNFα in serum and dialysate. HD patients showed a significant increase in serum levels of IL-8 and also IL-6 and TNFαcompared to normal individuals (P<0.05, P<0.05 and P<0.01 respectively). HD duration influenced serum levels of IL-8 and TNFα since they were significantly higher in short-term HD patients than medium- or long-term HD patients (respectively P<0.05, P<0.00l for IL-8, and P<0.01, P<0.001 for TNFα Pre-HD IL-6 levels were not influenced by HD duration. No major modification of IL-8 serum levels could be evinced after and before HD sessions in the short-term group, but concentrations of this cytokine were significantly higher after HD in medium- and long-term HD patients (P<0.05, P<0.0l respectively). In contrast, HD session did not influence IL-6 and TNFα levels. We conclude that the cytokine profile is perturbed in uraemia and during dialysis, and that this should be considered as an inflammatory status. © 1994 European Dialysis and Transplant Association-European Renal Association.
