Skip Navigation


NDT Advance Access originally published online on April 23, 2007
Nephrology Dialysis Transplantation 2007 22(7):2094-2095; doi:10.1093/ndt/gfm236
This Article
Right arrow Extract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
22/7/2094    most recent
gfm236v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Libetta, C.
Right arrow Articles by Dal Canton, A.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Libetta, C.
Right arrow Articles by Dal Canton, A.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Reply

Sir,

We thank Dr Kazory and Dr Ejaz for their interest in our study [1]. There is conflicting evidence for the role of dialytic clearance of BNP; it is clear that larger studies are required to assess thoroughly the impact of the dialysis process on serum BNP levels [2]. In our study, iHDF induces rapid and significant decreases of BNP, and levels of BNP rise slowly, not immediately, but only after 30 days.

Second question: accumulating evidence indicates that pro-inflammatory cytokines play a pathogenic role in CHF by influencing heart contractility, inducing hypertrophy, and promoting apoptosis or fibrosis, contributing to the continuous myocardial remodelling process [3,4]. Our study demonstrated a significant reduction of pro-inflammatory cytokines IL-8 and MCP-1 in iHDF patients, while TGF-ß and IL-10 levels remained unchanged and below detection limits. Therefore, the balance between pro-inflammatory (reduced) and anti-inflammatory (unchanged) cytokines is favourable in CHF patients on iHDF; in other words, iHDF removing pro- inflammatory cytokines can partially improve the inflammatory state.

We agree that the potential impact of iHDF on CHF-associated chronic inflammatory state should be further evaluated in future prospective studies.

Conflict of interest statement. None declared.

Carmelo Libetta1, Vincenzo Sepe1, Manuela Zucchi1, Patrizia Pisacco1, Laura Cosmai1, Federica Meloni2, Carlo Campana3, Teresa Rampino1, Cristina Monti4, Luigi Tavazzi3 and Antonio Dal Canton1

1Units of Nephrology,
Dialysis, Transplantation
2Department of Respiratory Diseases
IRCCS Policlinico San Matteo and
University of Pavia
3Department of Cardiology and
4Department of health sciences
section of epidemiology and
medical statistics,
University of Pavia Pavia
Italy

References

  1. Libetta C, Sepe V, Zucchi M, et al. Intermittent haemodiafiltration in refractory congestive heart failure: BNP and balance of inflammatory cytokines. Nephrol Dial Transplant (2007) [Epub ahead of print].
  2. Lee SW, Song JH, Kim GA, Lim HJ, Kim MJ. Plasma brain natriuretic peptide concentration on assessment of hydration status in hemodialysis patient. Am J Kidney Dis (2003) 41:1257–1266.[CrossRef][ISI][Medline]
  3. Mann DL, Young JB. Basic mechanisms in congestive heart failure: recognizing the role of proinflammatory cytokines. Chest (1994) 105:897–904.[ISI][Medline]
  4. Magga J, Martilla M, Mantymaa P, Vuolteenaho O, Ruskuaho H. Brain natriuretic peptide in plasma, atria, and ventricles of vasopressin- and phenylephrine-infused conscious rats. Endocrinology (1994) 134:2505–2515.[Abstract]

Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?



This Article
Right arrow Extract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
22/7/2094    most recent
gfm236v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Libetta, C.
Right arrow Articles by Dal Canton, A.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Libetta, C.
Right arrow Articles by Dal Canton, A.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?