Neutrophil activation in acute renal failure and sepsis
W. H. Horl, R. M. Schafer, M. Horl and A. Heidland
Department of Medicine, University of Freiburg, Federal Republic of Germany.
Neutrophils are activated during sepsis. To find out whether granulocytes
are further activated during hemodialysis with cellulosic and noncellulosic
membranes, we compared the plasma levels of the main granulocyte components
in patients with chronic uremia who were undergoing regular hemodialysis
treatment and patients with acute renal failure with and without sepsis.
During hemodialysis with cuprophane dialyzers, plasma-granulocyte elastase,
in complex with alpha-proteinase inhibitor, and lactoferrin levels
increased in patients who were undergoing regular hemodialysis treatment,
but these levels increased further in patients with acute renal failure who
did not have sepsis. Maximal neutrophil degranulation was observed in
patients with acute renal failure and sepsis. There was only mild
degranulation in all three groups during dialysis with dialyzers made of
polysulfone. Our data demonstrate that neutrophil activation is increased
in patients with acute renal failure, and it is increased further by
superimposed sepsis. Cellulose-containing dialysis membranes introduce a
further activation of neutrophils.
