Cytokine production by mononuclear cells from patients with chronic renal failure.

The interleukins play a central role in the regulation of the immune system function. In the present study we compared the ability of peripheral blood mononuclear cells (PBMC) from three groups of uremic patients and 15 healthy controls to release interleukin-2 (IL-2) and interleukin-3-like activity (IL-3-LA). In the first group, 11 patients with chronic renal failure (CRF) not yet on dialysis treatment, IL-2 and IL-3-LA were similar to those of the controls. The finding of an increased IL-2 activity in the CRF group suggests that factors other than membrane blood interactions are involved in its production. In the second group, 15 patients on hemodialysis (HD), Il-2 activity measured pre-HD was higher than in the control group (P < 0.005) but decreased slightly post-HD; and IL-3-LA pre-HD was higher than in the controls but decreased post-HD. The pre-HD high levels of IL-2 and IL-3-LA support the role of membrane blood interactions in inducing cytokine activity. In the third group, 13 patients on continuous ambulatory peritoneal dialysis (CAPD), IL-2 and IL-3-LA were similar to the controls. The normal values found in the CAPD group suggest that this modality of dialysis leads to a more normal cytokine production and thus may prevent complications observed in acute and chronic hemodialysis.