High-flux and Low-flux Dialysis Membranes and Levels of Intercellular Adhesion Molecule-1 and Vascular Cell Adhesion Molecule-1 in Children With Chronic Kidney Failure

Abstract

Introduction. During hemodialysis, the expression of different adhesion molecules changes, thus serving as markers of biocompatibility of dialysis membranes. Our aim was to investigate whether low-flux and high-flux dialysis membranes have different effects on the concentration of adhesion molecules and their association with leukocytes and pro-inflammatory cytokines.

Materials and Methods. We enrolled 80 pediatric patients on hemodialysis. Baseline levels of intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) were measured. The patients were classified into 2 groups to use either low-flux filters or high-flux filters for 3 months. At the end of the 3 months, predialysis samples were obtained for measurement of ICAM-1, VCAM-1, TNF-alpha and interleukin-1. Post-dialysis samples were collected for measurement of CBC, ICAM-1, VCAM-1, TNF-alpha, and interleukin-1. Forty volunteers were involved as a control group.

Results. Both TNF- ? and IL-1 were higher in the patients compared to the control group (P < .001). Compared to the control group, there was a significant increase in ICAM-1 and VCAM-1 (P < .001) in both groups predialysis and postdialysis. The postdialysis increments of ICAM-1 with the high-flux membranes were significantly less compared to the low-flux membranes (P < .001). Serum ICAM-1 and VCAM-1 significantly correlated with TNF-? and interleukin-1 in all groups.

Conclusions. The postdialysis increments of the adhesion molecules are due to the effect of dialysis membranes, which is less with the use of high-flux filters.