NEOPTERIN LEVELS IN PATIENTS UNDERGOING CHRONIC HEMODIALYSIS

Both uremia and bioincompatibility of hemodialysis result in a chronic systemic inflammatory syndrome. There is evidence for the activation of monocytes and subsequent release of several proinflammatory cytokines in uremic patients. Neopterin is a low molecular weight product released by human macrophages upon stimulation with interferon gamma. It permits the quantification of the level of cellular immune activation in vivo. The aim of our investigation was to characterize neopterin levels in patients without systemic infection undergoing chronic dialysis therapy. Forty-six patients on chronic hemodialysis and 40 healthy controls were selected for the study on the basis of absence of any clinical evidence for infections during the last 3 weeks prior to the study. Our data show the presence of higher serum levels of neopterin in hemodialysed subjects with respect to the controls ( 53.9±17.8 vs 12.3±3.8 nmol/l; p<0.0001). On average the neopterin levels decreased from 53.9±17.8 nmol/l at baseline to 40.0±15.6 nmol/l at the end of hemodialysis (p<0.001). According to our results, raised neopterin levels before and after hemodialysis therapy confirm the presence of a chronic systemic inflammatory state in hemodialysis patients.