THE EFFECT OF DIALYSIS THERAPY AND RECOMBINANT HUMAN ERYTHROPOITEIN ON LEUKOCYTE CHEMOTAXIS AND SPONTANEOUS MIGRATION IN PATIENTS WITH CHRONIC RENAL FAILURE

It is known that neutrophil chemotaxis and phagocytosis which are very important in primary host defense are damaged in chronic renal failure (CRF) patients. It has been shown that recombinant human erythropoietin (rEPO) corrects leukocyte phagocytosis. But, there is not enough data in the literature about the effect of rEPO on neutrophil chemotaxis and spontaneous migration. For the reason, we have designed this study to assess the effect of rEPO on neutrophil functions in dialysis patients. Ten hemodialysis (HD, group 1), twelve continuous ambulatory peritoneal dialysis (CAPD, group 2) and seven predialytic (group 3), totaly 29 CRF patients enrolled in this study. In addition, ten healthy volunteers (group 4) were studied as a control group. Boyden-chamber method was used to assess neutrophil chemotaxis and spontaneous migration. Six HD, three CAPD, totally nine patients (group 5) who had hemoglobin < 8.5 g/dl were given rEPO 100 U/kg, three times a week, subcutaneously for 30 days. Neutrophil chemotaxis and spontaneous migration were investigated again on days 1, 7 and 30 in 5th group. Chemotactic activity was lower in group 2 compared to group 3 (p= 0.03), and was also lower in groups 1 and 2 than in group 4 (p=0.0009, p=0.0002). Spontaneous migration was found lower in groups 1 and 2 than in group 4 (p=0.04, p=0.01). Chemotactic capacity was increased significantly on day 7 according to day 1 (p=0.01) and also day 30 compared to days 0 and 1 in group 5 (p= 0.02, p =0.03). Spontaneous migration was higher on day 30 than days 0 and 1 in the last group (p=0.02, p=0.02) In conclusion, these findings suggested that neutrophil functions are more destroyed in CAPD patients than in prediatytic patients, and in HD and CAPD patients than in healthy individuals, and this defect was partially improved by rEPO use.