Effects of Different Dialysis Strategies on Inflammatory Cytokine Profile in Maintenance Hemodialysis Patients with COVID-19: A Randomized Trial
Uncontrolled inflammation plays a relevant role in the pathogenesis of coronavirus disease-19 (COVID-19). Here, we studied the time trend of inflammatory markers in a population of hemodialysis (HD) patients affected by COVID-19, undergoing two different dialysis approaches. In a prospective study,...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/7/1383 |
| _version_ | 1797539544369725440 |
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| author | Pasquale Esposito Leda Cipriani Daniela Verzola Maria Antonietta Grignano Mara De Amici Giorgia Testa Fabrizio Grosjean Elisa Russo Giacomo Garibotto Teresa Rampino Francesca Viazzi |
| author_facet | Pasquale Esposito Leda Cipriani Daniela Verzola Maria Antonietta Grignano Mara De Amici Giorgia Testa Fabrizio Grosjean Elisa Russo Giacomo Garibotto Teresa Rampino Francesca Viazzi |
| author_sort | Pasquale Esposito |
| collection | DOAJ |
| description | Uncontrolled inflammation plays a relevant role in the pathogenesis of coronavirus disease-19 (COVID-19). Here, we studied the time trend of inflammatory markers in a population of hemodialysis (HD) patients affected by COVID-19, undergoing two different dialysis approaches. In a prospective study, thirty-one maintenance HD patients with COVID-19 were randomized to expanded HD (HDx), performed using a medium cut-off membrane, or standard treatment using a protein-leaking dialyzer (PLD). Circulating levels of interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10), soluble TLR4 (sTLR4), and interferon-gamma (IFN-γ), were collected at diagnosis, and one and two weeks after. Compared with 14 non-infected HD patients, COVID-19 patients showed lymphopenia and higher ferritin and lactate dehydrogenase levels. Moreover, COVID-19 patients had higher levels of IL-10 (15.2 (12.5) vs. 1.2 (1.4) pg/mL, <i>p</i> = 0.02). Twenty-nine patients were randomized to HDx (n = 15) or PLD (n = 14). After a single treatment, IL-8 showed a significant reduction in both groups, whereas IL-10 decreased only in HDx. All over the study, there were no significant modifications in circulating cytokine levels between the two groups, except for a parallel increase of IL-8 and IL-10 at one week control in the HDx group. No correlations were found between cytokine levels and clinical outcomes. In maintenance HD patients, COVID-19 is not related to a sustained inflammatory response. Therefore, modulation of inflammation seems not to be a suitable therapeutic target in this specific population. |
| first_indexed | 2024-03-10T12:47:21Z |
| format | Article |
| id | doaj.art-59c34b776fef418d9887b1e7595bfef6 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T12:47:21Z |
| publishDate | 2021-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-59c34b776fef418d9887b1e7595bfef62023-11-21T13:23:40ZengMDPI AGJournal of Clinical Medicine2077-03832021-03-01107138310.3390/jcm10071383Effects of Different Dialysis Strategies on Inflammatory Cytokine Profile in Maintenance Hemodialysis Patients with COVID-19: A Randomized TrialPasquale Esposito0Leda Cipriani1Daniela Verzola2Maria Antonietta Grignano3Mara De Amici4Giorgia Testa5Fabrizio Grosjean6Elisa Russo7Giacomo Garibotto8Teresa Rampino9Francesca Viazzi10Department of Internal Medicine, University of Genova, 16132 Genova, ItalyDepartment of Internal Medicine, University of Genova, 16132 Genova, ItalyDepartment of Internal Medicine, University of Genova, 16132 Genova, ItalyUnit of Nephrology, Dialysis and Transplantation, Fondazione IRCCS Policlinico San Matteo, and University of Pavia, 27100 Pavia, ItalyLaboratory of Immuno-Allergology of Clinical Chemistry and Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, ItalyPediatrics Clinic, Fondazione IRCCS Policlinico San Matteo, University of Pavia, 27100 Pavia, ItalyUnit of Nephrology, Dialysis and Transplantation, Fondazione IRCCS Policlinico San Matteo, and University of Pavia, 27100 Pavia, ItalyDepartment of Internal Medicine, University of Genova, 16132 Genova, ItalyDepartment of Internal Medicine, University of Genova, 16132 Genova, ItalyUnit of Nephrology, Dialysis and Transplantation, Fondazione IRCCS Policlinico San Matteo, and University of Pavia, 27100 Pavia, ItalyDepartment of Internal Medicine, University of Genova, 16132 Genova, ItalyUncontrolled inflammation plays a relevant role in the pathogenesis of coronavirus disease-19 (COVID-19). Here, we studied the time trend of inflammatory markers in a population of hemodialysis (HD) patients affected by COVID-19, undergoing two different dialysis approaches. In a prospective study, thirty-one maintenance HD patients with COVID-19 were randomized to expanded HD (HDx), performed using a medium cut-off membrane, or standard treatment using a protein-leaking dialyzer (PLD). Circulating levels of interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10), soluble TLR4 (sTLR4), and interferon-gamma (IFN-γ), were collected at diagnosis, and one and two weeks after. Compared with 14 non-infected HD patients, COVID-19 patients showed lymphopenia and higher ferritin and lactate dehydrogenase levels. Moreover, COVID-19 patients had higher levels of IL-10 (15.2 (12.5) vs. 1.2 (1.4) pg/mL, <i>p</i> = 0.02). Twenty-nine patients were randomized to HDx (n = 15) or PLD (n = 14). After a single treatment, IL-8 showed a significant reduction in both groups, whereas IL-10 decreased only in HDx. All over the study, there were no significant modifications in circulating cytokine levels between the two groups, except for a parallel increase of IL-8 and IL-10 at one week control in the HDx group. No correlations were found between cytokine levels and clinical outcomes. In maintenance HD patients, COVID-19 is not related to a sustained inflammatory response. Therefore, modulation of inflammation seems not to be a suitable therapeutic target in this specific population.https://www.mdpi.com/2077-0383/10/7/1383COVID-19hemodialysisexpanded hemodialysisprotein-leaking dialyzercytokinesinflammaging |
| spellingShingle | Pasquale Esposito Leda Cipriani Daniela Verzola Maria Antonietta Grignano Mara De Amici Giorgia Testa Fabrizio Grosjean Elisa Russo Giacomo Garibotto Teresa Rampino Francesca Viazzi Effects of Different Dialysis Strategies on Inflammatory Cytokine Profile in Maintenance Hemodialysis Patients with COVID-19: A Randomized Trial Journal of Clinical Medicine COVID-19 hemodialysis expanded hemodialysis protein-leaking dialyzer cytokines inflammaging |
| title | Effects of Different Dialysis Strategies on Inflammatory Cytokine Profile in Maintenance Hemodialysis Patients with COVID-19: A Randomized Trial |
| title_full | Effects of Different Dialysis Strategies on Inflammatory Cytokine Profile in Maintenance Hemodialysis Patients with COVID-19: A Randomized Trial |
| title_fullStr | Effects of Different Dialysis Strategies on Inflammatory Cytokine Profile in Maintenance Hemodialysis Patients with COVID-19: A Randomized Trial |
| title_full_unstemmed | Effects of Different Dialysis Strategies on Inflammatory Cytokine Profile in Maintenance Hemodialysis Patients with COVID-19: A Randomized Trial |
| title_short | Effects of Different Dialysis Strategies on Inflammatory Cytokine Profile in Maintenance Hemodialysis Patients with COVID-19: A Randomized Trial |
| title_sort | effects of different dialysis strategies on inflammatory cytokine profile in maintenance hemodialysis patients with covid 19 a randomized trial |
| topic | COVID-19 hemodialysis expanded hemodialysis protein-leaking dialyzer cytokines inflammaging |
| url | https://www.mdpi.com/2077-0383/10/7/1383 |
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