Inflammatory Mediators and Body Composition in High-Dose Online Hemodiafiltration and Expanded Hemodialysis

Background: In patients with chronic kidney disease and hemodialysis, factors such as chronic inflammation and protein energetic waste (PEW) lead to cardiovascular complications and increased mortality. We compared inflammatory mediators and body composition in patients after three months of online hemodiafiltration (OLHDF) and expanded hemodialysis (HDx). Methods: The present was a prospective and longitudinal study. Fourteen patients in OLHDF were compared with 16 patients in HDx. Vitamin B12 and cytokines (IL-12p70, TNF-a, IL-10, IL-6, IL-1b & IL-8) were measured in blood. Vitamin B12 was assessed by ELISA kit. Cytokines levels were quantified by flow cytometry. Body composition analysis was performed using InBody BWA2. All determinations were performed at baseline and after three months of treatment. Treatment comparisons were carried out using Student t test or Mann Whitney U test according to data distribution. Results: After 3 months in OLHDF [convective volume (23.8 L ± 2.1)], we did not observe a significant change in pro-inflammatory and anti-inflammatory cytokines. However, IL-10 [1.6 (1.3, 1.) to 1.1 (1.0, 1.5) (p = 0.025)] decreased in patients after 3 months on HDx (Table 1). On the other hand, Vitamin B12 increased by almost 40% after 3 months on HDx [161 ± 41 to 240 ± 76 (p < 0.001)]. Patients in the HDx group had higher fat mass and visceral fat values; however, these variables did not change after three months. Markers of sarcopenia and PEW were adequate in both groups. Conclusion: Patients in OLHDF and HDx maintain stable levels of proinflammatory cytokines. However, HDx patients did show differences in serum IL-10 and vitamin B12 concentrations after 3 months. The body composition of the patients had no relationship with the differences found between the groups.