Hemodialysis is associated with changes in plasma protein N-glycan profile: possibly promoting expression of anti-inflammatory traits

Introduction Biomarkers capable of predicting outcomes in patients undergoing hemodialysis (HD) remain limited. N-glycosylation of plasma proteins plays an important role in numerous biological processes, including immune regulation and inflammation. Alterations in N-glycan profiles have been described in several diseases, including chronic kidney disease (CKD). However, studies investigating N-glycosylation in dialysis patients are scarce, particularly in those receiving hemodialysis. Patients and methods We included 55 patients undergoing chronic hemodialysis who provided informed consent. Demographic data, comorbidities, and dialysis-related parameters were collected. Along with C-reactive protein analyses, the N-glycan profile of total plasma proteins was measured before hemodialysis, immediately after the procedure, and 24 hours later. Measurements were performed before the first dialysis session of the week, following the longest interdialytic interval (three days). C-reactive protein (CRP) was measured using immunoturbidimetry. Total plasma protein N-glycan profiles were analyzed using ultra-high performance liquid chromatography based on hydrophilic interactions with fluorescence detection (HILIC-UHPLC-FLR). Results Our study showed that in our patient cohort, sialylsation and fucosylation, as previously published data in which these traits are associated with proinflammatory milleu in various diseases/conditions, are proinflammatory traits in total plasma proteins N-glycosylation profile. Our findings demonstrate that hemodialysis itself possibly reduces pro-inflammatory glycosylation patterns, independently of changes in CRP levels. These results suggest that hemodialysis may exert biological effects beyond the removal of excess fluid and uremic toxins. Conclusion Hemodialysis may have a measurable anti-inflammatory effect in patients undergoing chronic treatment. Changes in the N-glycosylation profile of total plasma proteins may represent potential biomarkers for assessing hemodialysis effectiveness and predicting clinical outcomes in HD patients.