Inflammatory markers: Pentraxin 3, Interleukin10 and Interleukin18 in children with Chronic Kidney Disease

Fadel, Fatina; Sabry, Samar; Galal, Rasha Essam Eldin; Mourad, Abbas Abdelfattah; Shouman, Mohamed; Mohamed, Hassanin

doi:10.21608/geget.2019.38024

Inflammatory markers: Pentraxin 3, Interleukin10 and Interleukin18 in children with Chronic Kidney Disease

Document Type : Original Article

Authors

¹ Department of Pediatrics, Faculty of Medicine, Cairo University

² Department of Pediatrics, National Research Centre, Cairo, Egypt.

³ Pediatric Department, National Research Centre, Cairo, Egypt.

10.21608/geget.2019.38024

Abstract

Background
Inflammation is a major risk factor for cardiovascular (CV) complications and mortality in patients with ESRD. Patients with end stage renal disease (ESRD) strongly exhibit higher serum levels of inflammatory cytokines compared to healthy individuals.

Patients & Methods
The serum levels of proinflammatory cytokine IL-18, and anti-inflammatory IL-10 and of Pentraxin 3 were studied in sixty pediatric patients, aiming to compare the inflammatory status of children with end-stage renal disease on hemodialysis and those on conservative treatment; and to study the effect of vascular access and cardiac disease on those cytokines. Thirty patients had end stage renal disease on regular hemodialysis in Pediatric Nephrology Unit, Cairo University Children’s Hospital, fifteen patients had chronic kidney disease, on conservative therapy, in addition to fifteen healthy matched controls.

Results
The mean age of patients and duration of dialysis for the hemodialysis group was 11.93 ±3.79 and 6.03±2.46 years respectively while the other group was 8.46±3.63 years. Hemodialyzed patients had significantly higher post dialysis levels of Pentraxin3 and interleukin18 compared to pre dialysis levels with p value of 0.044 and 0.001 respectively. There was no difference regarding pre and post dialysis levels of interleukin10. Hemodialyzed patients had higher levels of Pentraxin3 and interleukin18 than conservative patients with P value of 0.006 and 0.01 respectively. Pentraxin3 and interleukin18 were higher in patients who dialyzed via central venous catheters than via Arteriovenous fistula with P value of 0.04, 0.002 respectively; while interleukin10 was lower with P value of 0.03.

Conclusion
Children with ESRD had higher post dialysis levels of inflammatory cytokines such as PTX3 and IL 18 than pre-dialysis levels. Also, they had higher levels than conservative patients. No significant difference as regard IL10 in both hemodialysis and conservative patients. IL10 was negatively correlated with cardio-vascular complications. Fourty percent of patients had cardio-vascular lesions proved by ECHO. The use of central venous catheter in HD patients is associated with increase in inflammatory markers. PTX3, IL18 were significantly higher in patients who dialyzed via CVC than those via A-V fistula.

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