Could there be Haemodynamic Stress Effects on Pro-Inflammatory CD14+CD16+ Monocytes during Convective-Diffusive Treatments? A Prospective Randomized Controlled Trial

Abstract

Background: The main aim is to compare the pro-inflammatory CD14+CD16+ monocytes blood levels in patient in end-stage renal disease (ESRD) undergoing Mixed online Haemodiafiltration (Mixed OL-HDF) vs. post-dilution OL-HDF and online high-efficiency haemodialysis. Methods: The study is a prospective double-blind randomized controlled cross-over trial. Dialysis monitor, membrane, duration and dialytic adequacy, volume ultrapure dialysate/infusion were the same in all treatments. Monocyte CD14+CD16+, CD14-CD16+, IL-2R, TNFα, IL-1β, IL-8, IL-6, IL-10, β2-microglobulin outcome were measured. Results: Mixed OL-HDF showed a less expression on the activated monocytes CD14+CD16+, CD14-CD16+ (–15.5%). There was no difference between cytokines and high sensitivity C-reactive protein and in other haemato-chemical inflammatory parameters except a significative decrease of TNF-α during Mixed OL-HDF. Conclusion: We found that Mixed OL-HDF could inhibit the CD14+CD16+ peripheral blood lymphocytes related to a less hemorheology stress inside capillary dialysis filter but in this study there is not still ascertainable its superiority compared to post OL-HDF and post OL-HEH.