Plasma
interleukin-1 beta (IL-1 beta) and
tumor necrosis factor-alpha (
TNF-alpha) were determined by ELISA in 17 healthy controls, 23 HD patients, 10
continuous ambulatory peritoneal dialysis patients, and 15
chronic renal failure patients, as well as in 2 HD patients experiencing pyrogenic reactions. Another group of 10 chronic HD patients were dialyzed for 2.5 h, 5 with first-use
Cuprophan membranes and 5 with first-use high-flux
cellulose triacetate membranes. The mean bacterial and
endotoxin concentrations of the
dialysate used for HD treatments during the study period were 18,440 +/- 530 CFU/mL (mean +/- SEM) and 976 +/- 205 pg/mL, respectively. Blood specimens were obtained intradialysis and postdialysis for
cytokine assay and were incubated to augment
cytokine production. There was no difference in plasma
IL-1 beta or
TNF-alpha concentrations among the healthy controls,
continuous ambulatory peritoneal dialysis patients,
chronic renal failure patients, or HD patients. Neither
cytokine increased significantly during or after HD. Two patients experiencing pyrogenic reactions had plasma
TNF-alpha concentrations of 537 and 413 pg/mL, compared with matched controls of 6 and 0 pg/mL.
Il-1 beta concentration did not differ from controls. We conclude that: (1) plasma
IL-1 beta and
TNF-alpha are not chronically elevated in
chronic renal failure,
continuous ambulatory peritoneal dialysis, or HD patients; (2) HD with new
Cuprophan or
cellulose triacetate membranes and high concentrations of
dialysate endotoxin and bacteria does not cause elevation of circulating
IL-1 beta or
TNF-alpha; and (3) pyrogenic reactions might be mediated by
TNF-alpha.