Microinflammation induces endothelial damage in hemodialysis patients: the role of convective transport

Kidney Int. 2007 Jul;72(1):108-13. doi: 10.1038/sj.ki.5002250. Epub 2007 Apr 11.


Cardiovascular complications are a major cause of mortality in hemodialysis patients. On-line hemofiltration combines convective clearance for removing large solutes with diffusion to remove small solutes and is associated with a significant reduction of inflammation and improved patient survival. We compared on-line hemofiltration to high-flux hemodialysis (HF-HD) in patients in a sequential manner. At baseline, 15 stable patients on HF-HD as compared with five control subjects showed significant increases in CD14+CD16+ cells, endothelial microparticles, and endothelial progenitor cells (EPCs). After 4 months of on-line hemofiltration, the number of CD14+CD16+ cells, microparticles, and EPCs decreased. After returning to HF-HD for 4 months, all measured parameters returned to their respective baseline values. The number of CD14+CD16+ cells correlated with both endothelial microparticles and EPCs. We conclude that on-line hemofiltration attenuates endothelial dysfunction possibly by decreasing microinflammation. This effect may be directly caused by a modulatory effect of on-line hemofiltration on proinflammatory cells or by a complex interaction that encompasses a wider removal of uremic toxins.

Publication types

  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Annexin A5 / metabolism
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / pathology
  • Cardiovascular Diseases / physiopathology
  • Cells, Cultured
  • Chronic Disease
  • Endothelium, Vascular / pathology
  • Endothelium, Vascular / physiopathology*
  • Female
  • Hemofiltration / methods*
  • Humans
  • Inflammation / pathology
  • Inflammation / physiopathology*
  • Kidney Diseases / complications
  • Kidney Diseases / physiopathology
  • Kidney Diseases / therapy*
  • Lipopolysaccharide Receptors / blood
  • Male
  • Middle Aged
  • Platelet Endothelial Cell Adhesion Molecule-1 / metabolism
  • Receptors, IgG / blood
  • Renal Dialysis / methods*
  • Stem Cells / metabolism
  • Stem Cells / pathology


  • Annexin A5
  • Lipopolysaccharide Receptors
  • Platelet Endothelial Cell Adhesion Molecule-1
  • Receptors, IgG