The Relationship of Inflammation Markers and Vascular Endothelial Indicators in Program Hemodialysis Patients in Sodium Deoxyribonucleate Treatment
The aim of the investigation was to study the dynamics and relationship of inflammatory process activity indicators and vascular endothelial condition in program hemodialysis (PHD) patients, sodium deoxyribonucleate being used in complex treatment.
Materials and Methods. The study involved 69 PHD patients with end-stage renal failure. The patients were randomized into two groups. Control group patients with PHD (n=35) received background therapy, while the patients of the treatment group (n=34) — background therapy and 75 mg (5 ml of 1.5% solution) of sodium deoxyribonucleate (Derinat, Technomedservice, Russia) intramuscularly (10 injections, every 24 h).
The content of interleukin-6, -1β, -10 (IL-6, IL-1β, IL-10), tumor necrosis factor alpha (TNF-α), endothelin (1-21) and von Willebrand factor (vWF) activity were analyzed using enzyme immunoassay, stable metabolites of nitric oxide (NO) — spectrophotometrically; of С-reactive protein (CRP) — by immunoturbidimetric method; of fibrinogen — using Klaus method.
The indices were assessed within three months: on day 1 (I examination, in treatment group — before sodium deoxyribonucleate administration), day 30 (II examination), and day 90 (III examination); at each of the mentioned stages — before hemodialysis procedure. Blood serum was the object of the research.
Results. There were observed an increased content of IL-6, IL-1β, IL-10, CRP, fibrinogen, NO and endothelin (1-21), and the decrease of TNF-α and vWF activity in relation to initial data.
Sodium deoxyribonucleate as part of complex background therapy of PHD patients reduced the levels of IL-6, IL-1β, CRP (day 30) and fibrinogen (days 30 and 90), with the increase in IL-10 level (day 30) in relation to both: initial indices and control group indices. TNF-α content decreased only in relation to the initial level; and on day 30 it was higher than the similar index in the control group. We observed the lower NO level compared to the background therapy (days 30 and 90), but higher vWF activity (day 30).
PHD patients were found to have the interaction of the changes of inflammation markers and endothelial condition indices. However, in sodium deoxyribonucleate administration the range of the correlation-dependent indices changed in comparison with those in background therapy. Therefore, we recommend a follow-up of inflammatory markers and vascular endothelial condition indices if sodium deoxyribonucleate is used as part of complex therapy for PHD patients.
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