Acute Effects Of Hemodialysis Research Articles

Acute Effect of Hemodialysis on Cognition in Patient of End Stage Renal Disease

Aim
 To assess effect of hemodialysis on cognitive control.
 Introduction
 Studies till date have not confirmed the immediate effect of hemodialysis on cognitive function. Cognitive control consists of core cognitive functions such as working memory and inhibition. In several studies it was observed that patients performed worse than healthy control in terms of fluency, working memory, inhibitory control, cognitive flexibility, and decision-making. This study was specifically designed to observe the effect of hemodialysis on learning and memory (Cognitive Control) in fifty ambulatory male subjects of end stage renal disease undergoing twice a week hemodialysis of age more than 21years.
 Material and Method
 Subjects on hemodialysis for more than 2 months up to a year were only included. They were instructed about methodology of Stroop color Word Test, Backward digit span Test and Ray Auditory Verbal learning Test. Following instruction on methodology they were given five practice sessions. They were then tested before and after hemodialysis.
 Result
 Post hemodialysis, the reaction time for Stroop color condition, Stroop word condition and Strop color word condition was less and this was found to be statistically significant when compared to pre hemodialysis. This indicates an improvement in executive control acutely after dialysis. If we look at backward digit span test and RAVLT total score, delayed recall and average recall no significant change was seen. The RAVLT immediate recall time changed significantly after hemodialysis.
 Conclusion
 There is acute effect of hemodialysis on executive function (cognitive control) domain of cognition.

Acute Effect of Hemodialysis on Cognition in Patient of End Stage Renal Disease

Acute Effect of Hemodialysis on Cognition in Patient of End Stage Renal Disease

Acute effects of haemodialysis on circulating microparticles.

BackgroundMicroparticles (MPs) are small cell membrane-derived vesicles regarded as both biomarkers and mediators of biological effects. Elevated levels of MPs have previously been associated with endothelial dysfunction and predict cardiovascular death in patients with end-stage renal disease. The objective of this study was to measure change in MP concentrations in contemporary haemodialysis (HD).MethodsBlood was sampled from 20 consecutive HD patients before and 1 h into the HD session. MPs were measured by flow cytometry and phenotyped based on surface markers.ResultsConcentrations of platelet (CD41+) (P = 0.039), endothelial (CD62E+) (P = 0.004) and monocyte-derived MPs (CD14+) (P < 0.001) significantly increased during HD. Similarly, endothelial- (P = 0.007) and monocyte-derived MPs (P = 0.001) expressing tissue factor (TF) significantly increased as well as MPs expressing Klotho (P = 0.003) and receptor for advanced glycation end products (RAGE) (P = 0.009). Furthermore, MPs expressing platelet activation markers P-selectin (P = 0.009) and CD40L (P = 0.045) also significantly increased. The increase of endothelial (P = 0.034), monocyte (P = 0.014) and RAGE+ MPs (P = 0.032) as well as TF+ platelet-derived MPs (P = 0.043) was significantly higher in patients treated with low-flux compared with high-flux dialysers.ConclusionDialysis triggers release of MPs of various origins with marked differences between high-flux and low-flux dialysers. The MPs carry surface molecules that could possibly influence coagulation, inflammation, oxidative stress and endothelial dysfunction. The clinical impact of these findings remains to be established in future studies.

Executive function in end-stage renal disease: Acute effects of hemodialysis and associations with clinical factors.

ObjectiveThere is evidence of cognitive impairment in patients with end-stage renal disease in hemodialysis (ESRD-HD). However, few studies have exhaustively analyzed executive functions (EFs) in this population, especially considering the influence of a wide range of clinical variables. This study analyzes performance in different EF components in ESRD-HD patients compared to a group of healthy controls (HCs), in addition to the acute effects of HD and the associations of cognitive performance with clinical variables.MethodEFs were evaluated pre- and post-HD in 43 ESRD-HD patients and 42 HCs, using a battery of tests designed to assess EF domains. Age, schooling, mood and blood pressure were statistically controlled. Associations between performance and clinical factors were computed by correlations and hierarchical multiple regression analyses.ResultsThe performance of the ESRD-HD patients was significantly lower than that of HCs in all the EF domains except for planning. Group differences were marginally significant for reasoning. HD produced no acute changes in global performance, with improvements see only in inhibition and working memory. EF scores were positively associated with total number of months previously transplanted, body mass index (BMI), dry weight, and levels of hemoglobin, albumin, ferritin, calcium, phosphorus, sodium, urea, and creatinine.ConclusionsGlobal EF functioning was lower in ESRD-HD patients than in HCs. No major acute HD-related EF changes were detected. These findings underline the importance of an adequate nutritional status for maintaining executive functioning in ESRD-HD patients.

OP-170 Acute Effects of Hemodialysis on Left and Right Ventricular Function Evaluated by Doppler Tissue Imaging

Purpose: Doppler tissue imaging (DTI) allows noninvasive assessment of both left ventricular (LV) and right ventricular (RV) function. The aim of this study was to evaluate the effect of hemodialysis (HD) on LV and RV function using DTI. Method: Our study group included 30 patients on chronic HD program (mean age 45 15 years). Myocardial (Sm, Em, Am) and annular velocities (Ea, Aa) were measured in several cardiac territories before and after HD. Results: After HD, Ea significantly reduced from 10.8 3.4 cm/s to 9.6 2.4 cm/s (p = 0.029). Patients exhibited a lower Em following HD in all measured territories. Em/Am ratio was also reduced for each LV wall investigated after HD in all measured territories. At the RV segments, Sm, Em, and Am decreased significantly in all measured territories. Em of the anterior wall was positively related to ultrafiltration volume (r = 0.25, p = 0.006), whereas the decrease of Sm of RV basal segment correlated with a decrease of diastolic blood pressure (r = 0.23, p < 0.01). Conclusion: Our data indicate that a single HD session is associated with acute changes of systolic and diastolic parameters of LV and RV.

Acute effects of haemodialysis on central venous and arterial pressure characteristics.

Haemodynamic stability of patients during haemodialysis (HD) sessions is of pivotal importance and accurate determination of dry weight remains a challenge. Little information is available about central venous and aortic pressure during dialysis. In this pilot study we used a non-invasive technique to describe the changes in central venous pressure (CVP) during dialysis. An ultrasound-assisted pressure-manometer was used at the cephalic vein during haemodialysis to quantify CVP. Central aortic pressure changes were assessed as aortic augmentation index and subendocardial viability ratio. Bioimpedance was applied to measure total body water, as well as extracellular and intracellular water before and after HD. Measurements were performed prior during and after 1 and 2 h on HD. Ten patients were included with a median age of 72 years (23-82). Haemodialysis reduced the weight by 2.0 kg, corresponding to a measured decrease in total body water of 1.9 L. The mean CVP showed a significant decrease (9.0-0.8 cmH₂O; P = 0.0005) during dialysis. The significant drop in CVP was found during the first hour (9-2.8 cmH₂O). Starting and stopping dialysis was reflected by a reduction of 2.6 cmH₂O and a rise of 2.8 cmH₂O (n.s.). Aortic augmentation index decreased from 26.1% to 21.0% (n.s.). Subendocardial viability ratio increased from 126% to 156% (P < 0.05) during HD, and decreased to 139% direct after HD (n.s.). This is the first study that illustrates a prominent reduction of CVP during the first hour of haemodialysis. Non-invasive CVP measurement is feasible during haemodialysis and adds another piece in the puzzle of factors involved in haemodynamic stability.

The Acute Effect of Hemodialysis on Choroidal Thickness.

Objective. To determine the effect of hemodialysis (HD) on choroidal thickness (CT). Methods. The right eyes of 41 patients with end-stage renal disease (ESRD) undergoing HD were included. All patients underwent an ophthalmic examination, including CT measurement via optical coherence tomography, intraocular pressure (IOP), blood pressure, and body weight measurement immediately before and after a HD session. Results. Mean subfoveal choroidal thickness (SFCT) after HD decreased significantly from 254.59 ± 84.66 µm to 229.34 ± 77.79 µm (p < 0.001). CT at the temporal and nasal regions also decreased significantly after HD (both p < 0.001). IOP changes after HD were insignificant (p = 0.958). CT difference was insignificant in patients with diabetes mellitus (DM) and without DM before and after HD, respectively (p = 0.285 and p = 0.707). Stepwise multivariate linear regression analysis showed that diastolic blood pressure was the best fitted factor to explain the changes in CT (r = 0.327 and p = 0.040). Conclusion. CT was decreased in the patients with ESRD following a HD session. This study suggested that the changes in CT may be related to the changes in systemic blood pressure.

Acute effects of hemodialysis on nitrite and nitrate: potential cardiovascular implications in dialysis patients

Cardiovascular mortality in dialysis patients remains a serious problem. It is 10 to 20 times higher than in the general population. No molecular mechanism has been proven to explain this increased mortality, although nitric oxide (NO) has been implicated. The objective of our study was to determine the extent of the removal of the NO congeners nitrite and nitrate from plasma and saliva by hemodialysis, as this might disrupt physiological NO bioactivity and help explain the health disparity in dialysis patients. Blood and saliva were collected at baseline from patients on dialysis and blood was collected as it exited the dialysis unit. Blood and saliva were again collected after 4–5h of dialysis. In the 27 patients on dialysis, baseline plasma nitrite and nitrate by HPLC were 0.21±0.03 and 67.25±14.68μM, respectively. Blood immediately upon exit from the dialysis unit had 57% less nitrite (0.09±0.03μM; P=0.0008) and 84% less nitrate (11.04μM; P=0.0003). After 4–5h of dialysis, new steady-state plasma levels of nitrite and nitrate were significantly lower than baseline, 0.09±0.01μM (P=0.0002) and 16.72±2.27μM (P=0.001), respectively. Dialysis also resulted in a significant reduction in salivary nitrite (232.58±75.65 to 25.77±10.88μM; P=0.01) and nitrate (500.36±154.89 to 95.08±24.64μM; P=0.01). Chronic and persistent depletion of plasma and salivary nitrite and nitrate probably reduces NO bioavailability and may explain in part the increased cardiovascular mortality in the dialysis patient.

Hemodialysis session reduces wave reflections but not aortic and brachial PWV in end-stage renal disease patients

Background: Increased arterial stiffness characterizes the vasculature of end-stage renal disease (ESRD) [1] and is a strong predictor of their cardiovascular morbidity and mortality [2]. Apart from the increase burden of traditional cardiovascular risk factors, a number of functional alterations associated with chronic kidney disease have been proposed as additional mechanisms for the accelerated arteriosclerosis in such patients [3]. However, the question whether renal replacement treatment per se affects large artery elasticity and reflecting properties of peripheral sites in ESRD patients on maintenance hemodialysis remains largely unanswered, as previous studies that evaluating the acute effect of hemodialysis on large artery elasticity gave contradictory results [4, 5].

Cardiac autonomic dysfunction in hemodialysis patients: The value of heart rate turbulence

Patients with end-stage renal disease (ESRD) are likely to have cardiac autonomic dysfunction, which is related with an increased risk of sudden death. The aim of this study is to detect cardiac autonomic dysfunction in patients with ESRD and to evaluate the possible acute effects of hemodialysis (HD) on cardiac autonomic functions measured by heart rate variability (HRV) and heart rate turbulence (HRT). Thirty-one (mean age 50 ± 13 years, 15 males) with ESRD on regular HD program and 31 healthy volunteers (mean age 51 ± 12 years, 15 males) were included in the study. Twenty-four-hour ambulatory electrocardiogram recordings were taken from the subjects before and after HD and from the control group. Heart rate variability and HRT parameters were calculated from these recordings. All of the HRV and HRT parameters were found to be significantly blunted in patients in comparison with healthy individuals. There were significant differences in HRV after HD, but similar differences were not observed in HRT parameters. Cardiac autonomic functions were significantly altered in patients with ESRD. Heart rate turbulence parameters seemed to be less affected from HD and may be more useful in the evaluation of cardiac autonomic functions in the ESRD population.

Acute effects of hemodialysis on oxidative stress parameters in chronic uremic patients: Comparison of two dialysis membranes

Uremic state and hemobioincompatibility are implicated in subclinical inflammation and oxidative stress and progression of atherosclerosis in the hemodialysis (HD) population. To what extent different dialysis membranes contribute to oxidative stress induced by a dialysis procedure per se is still a subject of debate. Fifteen HD patients and 15 healthy controls were enrolled in this study. Patients received two index HD sessions with a cuprophane and polysulfone membrane two weeks apart. Blood samples were collected at baseline and then before and after HD sessions. We determined serum thiobarbituric acid, protein carbonyl, and serum nitrite/nitrate levels as markers of oxidative damage. We also measured erythrocyte glutathione level, catalase, superoxide dismutase and glutathione peroxidase activity, and serum vitamin C and E levels as antioxidant markers. At baseline, HD patients, in comparison with normal controls, had a trend towards increased oxidant state and depletion of antioxidants. Cuprophane dialysis induced a higher increase in production of oxidants, along with a lower compensatory increase of antioxidants when compared with polysulfone dialysis. In conclusion, a single HD session, even when conducted with a biocompatible membrane, appears to play an important role in the imbalance between ROS production and antioxidant defense, but to a milder extent than cuprophane dialysis.

Oxidized Low-Density Lipoprotein Biomarkers in Patients with End-Stage Renal Failure: Acute Effects of Hemodialysis

Objective: To assess the effect of end-stage renal failure on oxidized low-density lipoprotein (OxLDL) biomarkers and the acute effects of hemodialysis. Oxidized phospholipids (OxPL) on apolipoprotein B-100 (apoB) particles (OxPL/apoB) have been associated with cardiovascular disease and new cardiovascular events. Patients with end-stage renal failure have increased oxidative stress and are at significantly increased risk of cardiovascular disease. Methods and Results: Fifty-two stable patients with end-stage renal failure undergoing chronic hemodialysis were included in the study. Pre and post hemodialysis blood samples were obtained for measurement of OxLDL biomarkers: oxidized phospholipids (OxPL) on apolipoprotein B-100 (apoB) particles (OxPL/apoB) measured by antibody E06, IgG and IgM autoantibody titers to copper-oxidized LDL (Cu-OxLDL) and malondialdehyde (MDA)-LDL, IgG and IgM apolipoprotein B-100-immune complexes (IC/apoB). Traditional laboratory variables as well as C-reactive protein (CRP) and lipoprotein(a) [Lp(a)] were also measured. For the baseline variables, the distribution of OxPL/apoB and Lp(a) were skewed to lower values, and a strong correlation was noted between OxPL/apoB and Lp(a) (r = 0.94, p < 0.0001). No major associations were noted between OxLDL biomarkers and age, gender or dialytic age. There were also no correlations between OxLDL biomarkers and traditional risk factors, CRP, body mass index, serum creatinine, hypertension or intravenous iron therapy. Following dialysis, there as a significant reduction in OxPL/apoB (–7.5%, p = 0.048) and triglyceride levels (–10.8%, p = 0.005). All other OxLDL biomarkers, CRP, total cholesterol, LDL-C, HDL-C and apoB-100 increased significantly (range 6.3–26.9%, p value range 0.005 to <0.0001). Total protein plasma levels increased 8.8% (p = 0.014 compared to predialysis) following dialysis, consistent with a hemoconcentration effect of hemodialysis. Conclusion: In end-stage renal failure patients undergoing hemodialysis, a reduction in OxPL/apoB levels was noted, despite the hemoconcentrating and strong pro-oxidant milieu of hemodialysis. Studies in larger populations of end-stage renal failure patients are needed to assess whether these findings predict future clinical outcomes.

The acute effect of hemodialysis on endothelial functions in patients with chronic renal failure

The acute effect of hemodialysis on endothelial functions in patients with chronic renal failure

Acute effects of hemodialysis on cytokine transcription profiles: Evidence for C-reactive protein-dependency of mediator induction

Chronic microinflammation increases cardiovascular morbidity in chronic hemodialysis (HD) patients. Previously published studies are controversial with respect to acute effects of HD treatment on up- or downregulation of cytokine protein levels. Twenty-nine chronic HD patients were hemodialysed for 4 h with a 4008 dialyser using high-flux membranes. Patients were separated into a low (up to 1 mg/dl) and a high (1.1 to 5.5 mg/dl) C-reactive protein (CRP) group. Blood was drawn before HD and 240 min after initiation of HD. Acute changes of transcript levels encoding pro- and anti-inflammatory mediators were analyzed in RNA stabilized immediately from blood leukocytes using microarray analysis (n=1) and quantitative real-time polymerase chain reaction (PCR) (Light Cycler) (n=29). In both patient groups, HD treatment significantly increased the transcript levels of several pro-inflammatory cytokines, such as tumor necrosis factor alpha and interleukin-8 (IL-8), and chemokine receptors such as C-X-C chemokine receptor type 4, C-C chemokine receptor type 7, and the fractakine receptor CX3C chemokine receptor 1. In the low CRP group, the increase of transcript levels for anti-inflammatory IL-1-receptor antagonist and of the receptor for the anti-inflammatory cytokines IL-10 and interferon gamma was significantly more pronounced than in the high CRP group. Subgroup analysis revealed no difference between diabetic vs non-diabetic patients. These observations point towards a marked influence of a routine hemodialysis treatment on transcription in leukocytes of pro- and anti-inflammatory cytokines and receptors relevant for microinflammation. Diminished upregulation of receptors for anti-inflammatory factors in HD patients with high CRP levels could contribute to enhanced microinflammation in those patients.

Acute effects of hemodialysis on lung function in patients with end-stage renal disease

Impaired lung function in hemodialysis patients may be caused by an underlying pulmonary disease; however, the impact of uremia and the effects of dialysis treatment are not well understood. Our investigation aimed to characterize the acute effects of bicarbonate hemodialysis using membranes differing in biocompatibility on various parameters of lung function in unselected uremic patients maintained on regular hemodialysis. Fourteen clinically stable hemodialysis patients without acute lung disease were included in the study. Restrictive lung disease was present in eight of 14 cases and obstructive lung disease in one patient. A cellulose dialyzer membrane and a synthetic high-flux dialyzer membrane were each tested twice (two sessions one week apart). Spirometry (VCmax, FEV1, FEF(25-75%), PEF) was carried out before and after hemodialysis. Resistance was determined with the interrupter technique and with the impulse oscillation system (R5Hz, R20Hz) before, during and after hemodialysis. Our comparative investigation of two dialyzer membranes found that bioincompatibility of dialysis had no acute adverse effects on lung function in our heterogeneous population of dialysis patients. None of our patients experienced bronchoconstriction or aggravation of obstructive lung disease as a result of poor biocompatibility of the dialyzer membrane. Spirometric data and resistance measurements by two different methods showed no relevant changes during the dialysis procedure. There was no correlation between lung function parameters and interdialytic changes in body weight or duration on hemodialysis. Regardless of the membrane used, the hemodialysis procedure does not acutely affect lung function in uremic patients on maintenance hemodialysis. Hemodialysis is a safe procedure even in uremic patients with pre-existing lung disease.

Acute Effect of Standard Heparin Versus Low Molecular Weight Heparin on Oxidative Stress and Inflammation in Hemodialysis Patients

Objective. Atherosclerotic cardiovascular diseases caused by traditional and non-traditional risk factors are the most common cause of morbidity and mortality in hemodialysis patients. Recently, much interest has been focused on non-traditional factors, such as oxidative stress, inflammation, and endothelial dysfunction. Hemodialysis patients are not only exposed to oxidative stress but also to inflammation. Although anticoagulants are the most frequently used drugs in hemodialysis patients, their effect upon oxidative stress and inflammation in dialysis patients are still unknown. Methods. Thirty-three hemodialysis patients were randomized into three groups. Group 1 received standard heparin while group 2 received low molecular weight heparin during the dialysis therapy. Group 3 (control group) did not receive any anticoagulant agent. Investigators were blinded to the therapy. Serum concentrations of oxidative stress and inflammation markers, including C-reactive protein, tumor necrosis factor alpha, superoxide dismutase, and malondialdehyde, were measured before and after dialysis session. Results. The oxidative stress and inflammation markers were significantly increased in groups 1 and 3 (p < 0.05 for each) compared to their baseline values. In contrast, baseline and end-treatment values of the oxidative stress and inflammation markers were comparable in the group 2 (p > 0.05). Conclusion. These findings indicate that the type of anticoagulants may take a role in the acute effect of hemodialysis upon oxidative stress and inflammation markers. A comparison of the groups revealed that low molecular weight heparin decreased the oxidative stress and inflammation, whereas standard heparin increased the oxidative stress and inflammation. Low molecular weight heparin appears to have an additive benefit for hemodialysis patients.

Tu-P7: 151 The acute effect of hemodialysis on endothelial functions in patients with chronic renal failure

Tu-P7: 151 The acute effect of hemodialysis on endothelial functions in patients with chronic renal failure

Acute effects of haemodialysis on endothelial function and large artery elasticity.

Disturbances of functional properties of large arteries contribute to increased cardiovascular morbidity and mortality in patients with end-stage renal disease. However, it is not clear whether haemodialysis per se acutely affects mechanical vessel wall properties or endothelial function. Twenty-five chronic haemodialysis patients (mean+/-standard error of the mean (SEM): age 52+/-5 years; time on dialysis 63+/-7 months; blood pressure 132+/-4/72+/-2 mmHg) were studied before and immediately after a haemodialysis (HD) session using a polysulphone dialyser (ultrafiltration 1460+/-54 ml), as well as on the following day. Blood pressure was measured with an automatic sphygmomanometer and applanation tonometry. End-diastolic diameter and distension of the brachial and carotid arteries were measured by Doppler frequency analysis of vessel wall movements in M-mode using a multigate pulsed Doppler system and aortic pulse wave velocity (PWV) by an automatic device (Complior). Endothelial function was determined as brachial artery flow-mediated dilation (FMD) and compared with endothelium-independent nitroglycerine-induced dilation (NMD). FMD was 7.9+/-1.8% in patients before HD and did not change significantly after HD or in the dialysis-free intervall (6.7+/-2.1 and 7.1+/-2.0%, respectively; NS). The same was true for NMD and PWV (12.6+/-0.8 m/s before HD, 12.8+/-0.8 m/s after HD, and 11.9+/-0.7 m/s on the HD-free day). Carotid distensibility coefficients decreased significantly during HD (from 18.1+/-1.9 x 10(-3)/kPa to 16.7+/-2.2 x 10(-3)/kPa, P<0.05) and increased again on the HD-free day (19.8+/-2.4 x 10(-3)/kPa). However, when corrected for blood pressure by tonometry, isobaric carotid distensibility did not change significantly. Brachial artery distensibility also did not show significant acute changes. Haemodialysis per se did not have a significant effect on endothelial function or large artery mechanical vessel wall properties in patients on maintenance dialysis therapy.

Effect of Hemodialysis on Left Ventricular Contractility in Pediatric Patients With End-Stage Renal Disease

Assessment of the effect of hemodialysis on myocardial contractility is complicated by variations in loading conditions that can occur during hemodialysis and by the prevalence of coronary artery disease among patients with chronic renal failure. Therefore, we used a load-independent index of left ventricular contractility, derived from analyses of the rate corrected velocity of circumferential fiber shortening (Vcfc)-end systolic wall stress (ESWS) relationship, to study the acute effects of hemodialysis on left ventricular function in the cases of 15 pediatric patients with end-stage renal disease. Prior to dialysis, Vcfc was appropriate for ESWS (102% +/- 16% of predicted) and did not differ significantly from values obtained from a group of nine normal control subjects of similar ages (103% +/- 9% of predicted), indicating that the patients' left ventricles were functioning in a normal inotropic state. After dialysis, Vcfc increased to levels beyond those expected for ESWS (118% +/- 20% of predicted, P < .05 versus control; P < .001 versus predialysis levels), indicating that dialysis was associated with enhancement of the left ventricle's inotropic state. A statistically significant increase in plasma norepinephrine levels was also observed. However, the increase in the percentage of the predicted Vcfc did not correlate with observed changes in this inotropic agent or with dialysis-induced variations in body weight or levels of electrolytes, urea nitrogen, or creatinine, and firm conclusions regarding the identity of the factors responsible for the positive inotropic effect of hemodialysis could not be drawn.

Effects of hemodialysis on activation of lymphocytes: analysis by an in vitro dialysis model.

Patients undergoing maintenance hemodialysis have impaired immune responsiveness, which appears to deteriorate progressively with the duration of the replacement treatment. It has been suggested that it is caused by a chronic preactivation state of T cells caused by hemodialysis. Each treatment session has been compared with a recurring "acute-phase" inflammatory reaction. In this study, the acute effects of hemodialysis on the activation state and functional responsiveness of normal peripheral blood mononuclear cells have been evaluated by use of an in vitro dialysis model. The dialysis was carried out with either cuprophan or polysulfone membranes, with or without sodium acetate in the dialysis fluid. It was observed that a single session of in vitro dialysis did not induce production of interleukin-2 (IL-2) and did not alter the expression of IL-2 receptor (IL-2R) on the cytoplasmic membrane and the secretion of soluble IL-2R, whereas it induced transcription of mRNA for IL-2R. The proliferative response of lymphocytes to phytohemagglutinin or IL-2 in vitro also did not change after a single dialysis session. There was only a slight decrease of the release of soluble IL-2 receptor by phytohemagglutinin-stimulated cells after dialysis. Dialysis induced an active synthesis of IL-1 by peripheral blood mononuclear cells, even in the absence of sodium acetate in the dialysate bath, but there was no release of IL-1 to the circulating medium. The results show that a single dialysis encounter can acutely prime the activation of human peripheral blood mononuclear cells.(ABSTRACT TRUNCATED AT 250 WORDS)