BACKGROUND The aetiology of postdialysis fatigue (PDF), an intermittent but debilitating fatigue occurring after haemodialysis (HD) treatment, is still unclear. In other inflammatory diseases, increasing evidence points toward the involvement of the immune system in the onset of fatigue symptoms. Altered serum levels of inflammatory cytokines have also been shown in HD patients. Therefore, we investigated whether pre- and postdialysis serum levels of pro- and anti-inflammatory cytokines (i.e. IL-1β, IL-6, TNF-α and IL-10) or their intradialytic changes (if any) were related to PDF or the time HD patients reported needing to recover from HD treatment (TIRD). METHODS Serum levels of IL-1β, IL-6, TNF-α and IL-10 were measured immediately before and after HD in 45 patients using commercially available kits on an ELLA™ automated immunoassay system. The presence and severity of PDF as well as TIRD duration were assessed by self-report measures. KEY RESULTS Seventy-four percent of patients reported PDF, with a median PDF severity index of 3.30 [IQR: 3.00-4.30] on a scale from 1 to 5. Median TIRD was 120 min [IQR: 60-480]. PDF severity correlated strongly with TIRD, rs = 0.85, p < 0.001. Only predialysis levels of IL-10 significantly and positively correlated with PDF severity (rs = 0.43, p = 0.003). CONCLUSION Findings of the present study do not support the involvement of the immune system in the onset of PDF or the time patients needed to recover from HD treatment. A positive, but counterintuitive relationship was found between predialysis levels of anti-inflammatory IL-10 and PDF severity, which warrants further research.

中文翻译：

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慢性血液透析患者透析期间血清细胞因子水平及其与透析后疲劳和恢复的关系——一项初步研究

背景 透析后疲劳 (PDF) 是一种在血液透析 (HD) 治疗后发生的间歇性但使人衰弱的疲劳，其病因尚不清楚。在其他炎症性疾病中，越来越多的证据表明免疫系统参与了疲劳症状的发作。在 HD 患者中也显示出血清炎症细胞因子水平的改变。因此，我们研究了透析前和透析后血清促炎和抗炎细胞因子（即 IL-1β、IL-6、TNF-α 和 IL-10）的水平或其透析中的变化（如果有的话）是否与 PDF 或HD 患者报告需要从 HD 治疗中恢复的时间 (TIRD)。方法 使用市售试剂盒在 ELLA™ 自动免疫分析系统上测量 45 名患者在 HD 前后即刻的 IL-1β、IL-6、TNF-α 和 IL-10 的血清水平。PDF 的存在和严重程度以及 TIRD 持续时间通过自我报告措施进行评估。主要结果 74% 的患者报告了 PDF，PDF 严重性指数中位数为 3.30 [IQR：3.00-4.30]，评分范围为 1 至 5。中位数 TIRD 为 120 分钟 [IQR：60-480]。PDF 严重程度与 TIRD 密切相关，rs = 0.85，p < 0.001。只有 IL-10 的透析前水平与 PDF 严重性显着正相关（rs = 0.43，p = 0.003）。结论 本研究的结果不支持免疫系统参与 PDF 的发作或患者从 HD 治疗中恢复所需的时间。在抗炎 IL-10 的透析前水平与 PDF 严重程度之间发现了一种积极但违反直觉的关系，这值得进一步研究。