Effect of renal replacement therapy on cellular cytokine production in patients with renal disease

To evaluate the effect of renal replacement therapy on cellular cytokine production in patients with renal disease, we studied interleukin 1 (IL-1) and interleukin-2 (IL-2) production by target cells stimulated with supernatants from cultured peripheral blood mononuclear cells from patients with end-stage renal disease, who were treated with hemodialysis and continuous ambulatory peritoneal dialysis (CAPD) before and after hemodialysis or a peritoneal dialysate exchange, compared to normal subjects used as time controls, and patients with chronic renal insufficiency. Initial cellular IL-2 production was increased in patients with hemodialysis, compared to normal controls. The ratio of pretreatment cellular IL-2 and IL-1 production was increased in all patient groups compared to normal subjects. Both hemodialysis and CAPD treatments resulted in increased cellular IL-1 (51.7%, P less than 0.007, and 42.8%, P less than 0.002, respectively) and IL-2 production (50.5%, P less than 0.015, and 33.3%, P less than 0.0008, respectively). The hemodialysis group had significantly higher cellular IL-2 production compared with normal controls' after treatment. After treatment, the IL-2/IL-1 ratio remained elevated in all groups with renal disease compared with normal subjects. We conclude patients with renal disease have an abnormal functional relationship between IL-1 and IL-2, characterized by increased IL-2 production per level of IL-1, unaffected by type or presence of renal replacement therapy.