Inflammatory status in chronic renal failure: The role of homocysteinemia and pro-inflammatory cytokines

Table 1 Clinical and biochemical characteristics of patients

	CRF 1 (n = 28)	CRF 2 (n = 28)	CRF 3 (n = 28)	CRF 4 (n = 18)	HD (n = 40)	PD (n = 12)
Age (yr)	37 ± 13	55 ± 11	45 ± 15	46 ± 14	42 ± 11	39 ± 15
Weight (kg)	66 ± 12.74	67 ± 16.12	67 ± 13.96	61 ± 13.87	56.44 ± 11.37	68.22 ± 10.55
BMI (kg/m2)	24.07 ± 7.16	25.35 ± 5.63	24.91 ± 3.54	23.63 ± 4.01	23.15 ± 3.02	25.43 ± 3.28
Sex ratio (M/F)	10/18	11/17	10/18	7/11	22/18	6/6
GFR (mL/min)	86.25 ± 23.87	46 ± 6.95	20.31 ± 5.10	10.75 ± 2.56	-	-
Dialysis duration (mo)	-	-	-	-	14-109	05-49
Glucose (g/L)	0.85 ± 0.12	0.85 ± 0.13	0.89 ± 0.10	0.83 ± 0.13	0.81 ± 0.16	0.87 ± 0.14
Urea (g/L)	0.34 ± 0.15	0.53 ± 0.20	1.05 ± 0.34	1.67 ± 0.82	1.32 ± 0.36	1.04 ± 0.38
Creatinin (mg/L)	10.30 ± 2.89	18.54 ± 5.26	41.75 ± 11.46	70.03 ± 26.15	102.12 ± 29.37	69.36 ± 36.95
Total proteins (g/L)	75.17 ± 5.21	74.29 ± 7.52	71.16 ± 11.15	70.86 ± 10.52	69.92 ± 9.60	67.04 ± 7.36
Albumin (g/L)	46.49 ± 3.48	44.43 ± 2.41	43.93 ± 3.86	42.75 ± 7.33	41.40 ± 4.48	40.32 ± 6.66
Cholesterol (g/L)	1.68 ± 0.33	1.89 ± 0.29	1.73 ± 0.32	1.74 ± 0.45	2.17 ± 1.58	1.95 ± 0.56
HDL-cholesterol (g/L)	0.53 ± 0.10	0.48 ± 0.09	0.50 ± 0.10	0.44 ± 0.11	0.36 ± 0.11	0.42 ± 0.07
LDL-cholesterol (g/L)	0.93 ± 0.33	1.13 ± 0.22	0.95 ± 0.93	0.94 ± 0.41	1.14 ± 0.51	1.21 ± 0.45
Triglycerides (g/L)	1.17 ± 0.53	1.39 ± 0.55	1.47 ± 0.74	1.30 ± 0.55	1.64 ± 0.90	1.75 ± 0.89
Aspartateaminotransferase (ASAT, TGO) (U/L)	25.26 ± 12.10	28.32 ± 12.78	22.49 ± 5.59	23.25 ± 11.03	17.49 ± 7.34	23.50 ± 11.50
Alanine aminotransferase (ALAT, TGP) (U/L)	21.74 ± 13.55	22.71 ± 15.80	12.88 ± 7.69	16.00 ± 7.24	16.31 ± 9.70	21.00 ± 17.26
Alkaline phosphatase (U/L)	68.42 ± 30.74	99.69 ± 47.16	92.88 ± 31.20	98.00 ± 29.55	88.73 ± 33.23	96.25 ± 32.63
Gamma-glutamyl transferase (U/L)	15 ± 7.11	26.94 ± 34.53	22.27 ± 12.19	28.17 ± 16.90	32.18 ± 20.40	26.00 ± 17.10
Hemoglobin (g/dL)	13.01 ± 1.36	12.28 ± 1.31	11.46 ± 1.53	8.71 ± 1.37	9.55 ± 1.86	10.38 ± 2.44

BMI: Body mass index (weight kg/height m²); GFR: Glomerular filtration rate; HD: Hemodialysis; PD: Peritoneal dialysis; M: Male; F: Female; HDL: High density lipoprotein; LDL: Low density lipoprotein. Data are spoken in mean ± SD.

Table 2 Inflammation markers, total homocysteine and cytokines in chronic renal failure patients

	CRF 1	CRF 2	CRF 3	CRF 4	HD	PD	P
TNF-α (pg/mL)	0.39 ± 0.03	3.81 ± 1.52	7.80 ± 2.76	10.04 ± 1.61	16.38 ± 5.52	14.04 ± 3.40	0.001
IL-1β (pg/mL)	3.24 ± 0.10	3.57 ± 0.47	6.69 ± 1.02	7.76 ± 0.66	9.63 ± 3.50	6.51 ± 1.37	0.001
IL-6 (pg/mL)	8.20 ± 0.22	8.79 ± 1.04	8.88 ± 0.71	9.66 ± 0.56	11.05 ± 3.59	10.15 ± 1.66	0.001
tHcy (μmol/L)	8.05 ± 2.43	11.95 ± 5.26	20.16 ± 2.62	25.34 ± 3.93	32.27 ± 12.08	28.37 ± 4.98	0.001
CRP (mg/L)	3.29 ± 2.33	5.54 ± 2.16	8.18 ± 3.33	13.5 ± 4.28	18.17 ± 6.38	17.97 ± 4.85	0.001
Fib (g/L)	3.58 ± 0.82	4.51 ± 0.47	5.80 ± 1.21	6.05 ± 0.57	6.86 ± 1.06	5.91 ± 0.59	0.001
Ferritin (ng/mL)	47.66 ± 25.24	51.12 ± 34.57	74.22 ± 43.18	83.83 ± 44.99	169.90 ± 62.16	90.08 ± 22.09	0.001
Transferrin (g/L)	2.73 ± 0.47	2.41 ± 0.23	2.29 ± 0.37	2.03 ± 0.49	1.86 ± 0.39	1.78 ± 0.21	0.001

Data are presented as the mean ± SD. Statistically significant differences between all the groups (P < 0.001). TNF-α: Tumor necrosis factor-α; IL-1β: Interleukin-1β; IL-6: Interleukin-6; tHcy: Total homocysteine; CRP: C-reactive protein; Fib: Fibrinogen; HD: Hemodialysis; PD: Peritoneal dialysis.

Table 3 Correlation among inflammation markers, total homocysteine and cytokines in chronic renal failure patients and glomerular filtration rate in uremic patients

	TNF-α	GFR
TNF-α	-	-0.75 P < 0.001
IL-1β	0.75 P < 0.001	-0.64 P < 0.001
IL-6	0.39 P < 0.001	-0.36 P < 0.001
tHcy	0.73 P < 0.001	-0.68 P < 0.001
CRP	0.72 P < 0.001	-0.71 P < 0.001
Fib	0.66 P < 0.001	-0.71 P < 0.001
Ferritin	-	-0.48 P < 0.001
Transferrin	-	0.60 P < 0.001

TNF-α: Tumor necrosis factor-α; IL-1β: Interleukin-1β; IL-6: Interleukin-6; tHcy: Total homocysteine; CRP: C-reactive Protein; Fib: Fibrinogen; GFR: Glomerular filtration rate.