EVALUATION OF THE ROLE OF MULTIPLE DIALYSIS SESSIONS IN PATIENTS WITH END-STAGE RENAL FAILURE ON CHEMERIN LEVELS, SOME CYTOKINES, AND SEVERAL BIOCHEMICAL PARAMETERS

Abstract

Purpose: Chronic Kidney Disease(CKD) is the case which results of a permanent and usually progressive reduction in kidney function then leads to many complications through a period of time, the dipokines, cytokines and biochemical parameters in patients’ blood are very important indicator of the health status of patients with chronic kidney failure who undergoing dialysis.

Methods: In this study taken 600 blood samples from 100 patients, immediately in patients undergoing hemodialysis before and after three dialysis sessions, and then tested it for Chemerin, IL-6, TNF-alpha and Vitamin-D with 20 biochemical parameter.

Results: The results showed that the levels of serum interleukin-6, tumor necrosis factor-a, Chemerin, Cholesterol, TG, amylase and ALP, significantly increased in patients before and after three dialysis sessions compared to healthy group, correspondingly the level of direct Bilirubin recorded no significant difference before and after three dialysis sessions comparing with control group. On the other hand, the results indicated a significant decreased in serum Vitamin-D, albumin, HDL, Ca+2, Na+, AST, ALT and T.Bilirubin. Urea, Creatinine, K+, Glucose and U.A, recorded a significant increase before dialysis while a significant decrease for S.TP compared with the control group. The results revealed the effect of dialysis membranes on the levels of parameters between pre and post-dialysis to 3 groups, first group showed a significant increase in LDH, while the second group showed a significant decrease in UA, S.K+, Urea and Cl-, finally in the third group, the dialysis membranes reduced the high levels of Creatinine and Glucose at pre-dialysis sessions where the levels in post-dialysis didn't show any significant difference compared with the control group.The results demonstrate that there is a significant positive correlation between Interleukin-6, Tumor necrosis factor-a and Chemerin with each other, whereas a significant negative correlation between Vitamin-D with Interleukin-6, Tumor necrosis factor-a and Chemerin.

Conclusion: The study concluded that increased circulating serum Chemerin, Interleukin-6 and Tumor necrosis factor-a, dyslipidemia and electrolytes disturbances with Vitamin-D deficiency in CKD patients at 3-dialysis stage, probably promotes progression of renal disease and could contribute to accelerate the atherosclerosis and cardiovascular disease and may increase the morbidity and mortality in these groups of patients.