Could there be Haemodynamic Stress Effects on Pro-Inflammatory CD14+CD16+ Monocytes during Convective-Diffusive Treatments? A Prospective Randomized Controlled Trial

Blood Purif. 2019;47(4):385-394. doi: 10.1159/000494711. Epub 2019 Jan 2.


Background: The main aim is to compare the pro-inflammatory CD14+CD16+ monocytes blood levels in patient in end-stage renal disease (ESRD) undergoing Mixed online Haemodiafiltration (Mixed OL-HDF) vs. post-dilution OL-HDF and online high-efficiency haemodialysis.

Methods: The study is a prospective double-blind randomized controlled cross-over trial. Dialysis monitor, membrane, duration and dialytic adequacy, volume ultrapure dialysate/infusion were the same in all treatments. Monocyte CD14+CD16+, CD14-CD16+, IL-2R, TNFα, IL-1β, IL-8, IL-6, IL-10, β2-microglobulin outcome were measured.

Results: Mixed OL-HDF showed a less expression on the activated monocytes CD14+CD16+, CD14-CD16+ (-15.5%). There was no difference between cytokines and high sensitivity C-reactive protein and in other haemato-chemical inflammatory parameters except a significative decrease of TNF-α during Mixed OL-HDF.

Conclusion: We found that Mixed OL-HDF could inhibit the CD14+CD16+ peripheral blood lymphocytes related to a less hemorheology stress inside capillary dialysis filter but in this study there is not still ascertainable its superiority compared to post OL-HDF and post OL-HEH.

Keywords: Hemodialysis; Mixed hemodiafiltration; Monocytes CD14+CD16+.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Cytokines / blood
  • Female
  • Hemodiafiltration
  • Hemodynamics*
  • Humans
  • Inflammation Mediators / blood
  • Leukocyte Count*
  • Lipopolysaccharide Receptors / metabolism
  • Male
  • Monocytes / immunology*
  • Monocytes / metabolism*
  • Nutritional Status
  • Prospective Studies
  • Receptors, IgG / metabolism
  • Renal Dialysis*
  • Stress, Physiological*


  • Biomarkers
  • Cytokines
  • Inflammation Mediators
  • Lipopolysaccharide Receptors
  • Receptors, IgG