Nephrology Dialysis Transplantation, Vol 14, Issue 5 1150-1157, Copyright © 1999 by Oxford University Press
F Mariano, G Guida, D Donati, C Tetta, P Cavalli, G Verzetti, G Piccoli and G Camussi
Background. Studies in experimental animals have
suggested that platelet-activating factor (PAF) is a mediator of
sepsis-associated acute renal failure (ARF). In the present study we have
evaluated whether an increased concentration of PAF within circulation of
urine of septic patients correlated with the worsening of renal function.
Methods. The concentration of PAF and selected
cytokines (TNF, IL-1, IL-6, IL-8) was evaluated in blood and urine of 12
patients with septic shock and ARF for 4 consecutive days.
Results. The data obtained indicate that blood and
urinary concentrations of PAF and of IL-1, IL-6 and IL-8 were significantly
higher in septic patients than in controls subjects and in patients with
chronic renal failure. The concentration of TNF was significantly increased
only in urine. A significantly positive correlation was found among blood
concentration of PAF and heart rate (r=0.4193,
P<0.017), serum creatinine
(r=0.3671, P<0.038), serum
IL-6 (r=0.5475, P<0.005)
and urine excretion of IL-8 (r=0.3984,
P<0.044), whereas a negative correlation was
present with the number of circulating platelets
(r=-0.4285, P<0.018).
Moreover, a positive correlation among the concentration of IL-6
(r=0.5654, P<0.006) and
urine excretion of IL-6 (r=0.6589,
P<0.0008) and IL-8
(r=0.6371, P<0.0004) were
found. Conclusions. These results demonstrate in
humans during ARF associated with septic shock the production of PAF, a
mediator that has been previously implicated in the pathogenesis of
experimental endotoxin-induced shock and renal injury. The observation that
blood and urinary concentrations of PAF correlated with some of the
Clinical and laboratory parameters related to the severity of ARF and
sepsis suggests that PAF may contribute to the development of renal injury
in septic patients. Keywords: acute renal failure;
cytokines; humans; platelet activating factor; septic shock
ORIGINAL ARTICLES
Production of platelet-activating factor in patients with sepsis-associated acute renal failure
Department of NephroUrology, Nephrology and Dialysis Unit, St Lazarus Hospital, Alba, Italy; Division of Nephrology and Dialysis, Azienda Ospedaliera Maggiore, Novara, Italy; Department of Nephrology, II Faculty of Medicine, University of Pavia, Varese, Italy; Clinical and Laboratory Research Department, Bellco S.p.A., Mirandola, Modena, Italy; Laboratory of Renal Immunopathology, Department of Internal Medicine, University of Turin, Torino, Italy; Corresponding author
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