[Inflammatory markers, nutritional parameters and polyunsaturated fatty acids in hemodialysis patients].

ABSTRACT

INTRODUCTION: Malnutrition and inflammation are associated with end-stage renal disease. Inflammation leads to reduced synthesis of albumin, transferin, and other negative acute-phase proteins and increases their catabolic rates. The causes of inflammation are multifactorial, including oxidative modification of plasma proteins, interaction of blood with nonbiocompatible membranes, and other infectious processes. Interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) powerfully predict death from cardiovascular disease in dialysis patients as well as progression of vascular injury. The aim of our study was to establish a correlation between markers of inflammation and parameters of malnutrition in hemodialysis patients. MATERIAL AND METHODS: We examined 42 hemodialysis patients at the mean age of 55+/-8 with dialysis duration 52.6+/-42. For nutritional assessment subjective global assessment (SGA), anthropometric parameters, bio-electric impedance (BIA), and biochemical nutritional parameters were used. We measured their plasma levels of inflammatory markers C-reactive protein, IL-6 and TNF-alpha. Patients with severe malnutrition had higher level of IL-6 and TNF-alpha. RESULTS AND DISCUSSION: The following correlations between measured parameters emerged. There was a negative correlations between serum albumin concentration and inflammatory markers (r=-0.31; p=0.05). Anthropometric parameters in hemodialysis patients were lower when inflammatory markers were higher and correlation was significant (p=0.05). A statistically significant negative correlation between TNF-alpha and EPA (r=-0.497; p<0.05) and IL-6 and EPA (r=-468; p=0.03) was found in hemodialysis patients. CONCLUSION: The main findings of this study were that the decrease of nutritional parameters in hemodialysis patients were related to the degree of inflammation. Nutritional factors, as essential fatty acids, could lead to permanent changes in the inflammatory process.