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KRONÎK BÖBREK YETMEZLIKLI HASTALARDA DÎYALÎZ TEDAVÎSÎ VE REKOMBÎNANT HUMAN ERÎTROPOÎETÎNÎN LÖKOSÎT KEMOTAKSÎSÎ VE SPONTAN MIGRASYONU ÜZERİNE ETKİSİ

THE EFFECT OF DIALYSIS THERAPY AND RECOMBINANT HUMAN ERYTHROPOITEIN ON LEUKOCYTE CHEMOTAXIS AND SPONTANEOUS MIGRATION IN PATIENTS WITH CHRONIC RENAL FAILURE

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 1997

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
It is known that neutrophil chemotaxis and pha¬gocytosis which are very important in primary host defense are damaged in chronic renal failure (CRF) patients. It has been shown that recombinant human erythropoietin (rEPO) corrects leukocyte phagocyto¬sis. But, there is not enough data in the literature abo¬ut the effect of rEPO on neutrophil chemotaxis and spontaneous migration. For the reason, we have de¬signed this study to assess the effect of rEPO on neut-rophilfunctions in dialysis patients. Ten hemodialysis (HD, group 1), twelve continuo¬us ambulatory peritoneal dialysis (CAPD, group 2) and seven predialytic (group 3), totaly 29 CRF pati¬ents enrolled in this study. In addition, ten healthy vo¬lunteers (group 4) were studied as a control group. Boyden-chamber method was used to assess neutrop-hil chemotaxis and spontaneous migration. Six HD, three CAPD, totally nine patients (group 5) who had hemoglobin < 8.5 g/dl were given rEPO 100 U/kg, three times a week, subcutaneously for 30 days. Neut-rophil chemotaxis and spontaneous migration were in¬vestigated again on days 1, 7 and 30 in 5th group. Chemotactic activity was lower in group 2 compared to group 3 (p= 0.03), and was also lower in groups 1 and 2 than in group 4 (p=0.0009, p=0.0002). Sponta¬neous migration was found lower in groups 1 and 2 than in group 4 (p=0.04, p=0.01). Chemotactic capa¬city was increased significantly on day 7 according to day 1 (p=0.01) and also day 30 compared to days 0 and 1 in group 5 (p= 0.02, p =0.03). Spontaneous migration was higher on day 30 than days 0 and 1 in the last group (p=0.02, p=0.02) In conclusion, these findings suggested that neut-rophilfunctions are more destroyed in CAPD patients than in prediatytic patients, and in HD and CAPD pa¬tients than in healthy individuals, and this defect was partially improved by rEPO use.
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Abstract (Original Language): 
Primer konak savunmasında önemli olan nötrofıl kemotaksis ve fagositozunun KBYde bozulduğu bilin¬mektedir. Rekombinant insan eritropoietini (rE-PO)'nin lökosit fagositozunu düzelttiği daha önce saptanmıştır. Ancak, nötrofillerin kemotaksis va spontan migrasyonu üzerine rEPO'nun etkisi ile ilgili veriler yetersizdir. Bu nedenle, hem KBY hastalarında diyali¬zin nötrofıl kemotaksisi ve spontan migrasyonu üzeri¬ne, hem de rEPO'nun diyaliz hastalarında nötrofıl fonksiyonları üzerine etkisini değerlendirmek amacı ile bu çalışmayı yaptık. On hemodiyaliz (HD; 1. grup), 12 sürekli ayaktan periton diyalizi (SAPD; 2. grup) hastası ve 7 kişi de konservatif tedavi uygulanan prediyalitik hasta (3.grup) olmak üzere toplam 29 KBYhastası çalışmaya alındı. Ayrıca 10 sağlıklı, gönüllü kişi kontrol grubu (4.grup) olarak alındı. Nötrofil kemotaksisi ve spontan migrasyonu Boyden-chamber yöntemi ile de¬ğerlendirildi. Hemoglobini 8.5 gl/dl'nin altında olan birinci gruptan altı ve 2.gruptan üç olmak üzere top¬lam dokuz hastaya (5. grup) rEPO lOOü/kg/haflada 3 gün, sc, 30 gün uygulandı. Beşinci grupta 1., 7. ve 30. günlerde nötrofıl kemotaksisi ve spontan migrasyonu tekrar çalışıldı. Kemotaksis 2. grupta 3. gruba göre (p=0.03), 1. ve 2. grupta ise 4. gruba göre anlamlı şekilde (p= 0. 0009, p=0.0002) daha düşüktü. Spontan migrasyon 1. ve 2.grupta 4. gruba göre anlamlı olarak (p=0.0,4, p=0.01 ) düşüktü. Beşinci grupta kemotaksis 7.gün l.güne göre (p=0.01), 3O.gün ise bazal ve l.güne göre anlamlı şekilde (p=0.02, p=0.02) daha yüksekti. Bu çalışmanın sonuçlan, SAPD hastalarında nöt-rofil fonksiyonlarının prediyalitik hastalara göre, hem HD hem de SAPD hastalarında ise sağlıklı bireylere göre anlamlı derecede bozuk olduğunu ve rEPO teda¬visi ile bunların kısmen düzeldiğini göstermektedir.
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  • Turkish

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