Phagocytic activity and oxygen radicals production of neutrophils in patients with chronic renal failure

: As disorders of the defense mechanism in hemodialysis (HD) patients, impairments of cell-mediated immunity have been known, but no agreement has yet been reached as to the function of their polymorphonuclear leukocytes (PMN). Thus this study was undertaken to determine the phagocytic activity and oxygen radicals production of PMN in patients with chronic renal failure (CRF). It was demonstrated that the phagocytic activity of PMN was significantly decreased in HD patients as compared with that in healthy subjects. A significant correlation was also found between phagocytic activity and FcR-positive cells of PMN in HD patients. It suggested that the FcR status of PMN might play an important role with phagocytic activity in HD patients, and the decrease of FcR-positive PMN affects the drop with phagocytic activity. Hydrogen peroxide production of prepared PMN was not significantly different for CRF patients versus healthy subjects. But in whole blood, the enhanced hydrogen peroxide production was observed in all CRF patients. And it was also demonstrated that PMN hydrogen peroxide production become strikingly enhanced when normal PMN was suspended in plasma from CRF patients. When normal renal function was restored by transplantation, hydrogen peroxide production was normalized. These results strongly suggested that the presence of the hydrogen peroxide production enhancing factor in plasma from CRF patients and the enhanced hydrogen peroxide production were specifically associated with renal dysfunction. In plasma of HD patient treated with the EVAL membrane, we measured the hydrogen peroxide production both before and after dialysis. The plasma of postdialysis showed slightly lower hydrogen peroxide production than that of predialysis in most of patients. It was also demonstrated that the plasma from CAPD patients showed a lower hydrogen peroxide production than that from other CRF patients. These results suggested that the hydrogen peroxide production enhancing factor could be considered as one of so called the middle molecules.