German study provides the first description of this inflammatory mediator in renal failure patients.


Pentraxin 3, a mediator of inflammation, is markedly elevated in patients on hemodialysis (HD) but not in patients on peritoneal dialysis (PD) or in patients with chronic renal failure (CRF) not on dialysis, according to researchers.

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Ralf Schindler, MD, of Universitäetsmedizin Berlin, Campus Virchow-Klinikum, Berlin, and his colleagues obtained plasma samples from 44 HD patients (mean age 59.8 years), 35 PD patients (mean age 55.6 years), 39 CRF patients not on dialysis therapy (mean age 60.4 years), and 14 age-matched normal subjects (mean age 60.3 years).


Pentraxin 3 (PTX3) levels were significantly higher in HD patients (5.8 ng/mL) than in the other groups, the authors reported in Nephrology Dialysis Transplantation (2007; published online ahead of print). The investigators observed no significant difference in PTX3 levels in the PD, CRF, and normal subjects (1.5, 1.5, and 0.76 ng/mL, respectively).


In addition, among the subjects with renal failure, PTX3 levels were significantly higher in those with CAD and peripheral artery disease compared with patients without these diseases. During a single HD session, PTX3 production was higher in whole blood samples taken after three hours of HD compared with samples obtained before HD.


“This increase in PTX3 production in whole blood after HD indicates that the HD procedure itself contributes to elevated PTX3 levels in HD patients,” the authors wrote. “The association between PTX3 and cardio-vascular morbidity suggests a possible connection of PTX3 with atherosclerosis and cardiovascular disease in HD patients.”


Moreover, C-reactive protein (CRP) levels were elevated in HD, PD, and CRF groups (0.8, 1.1, and 0.9 mg/dL, respectively) compared with normal subjects (0.12 mg/dL), but the CRP levels in the three renal failure groups did not differ significantly. The highest levels of interleukin-6 (IL-6), a pro-inflammatory cytokine, were observed in PD patients (10.8 pg/mL), followed by HD, CRF, and normal subjects (8.2, 4.0, and 2.5 pg/mL, respectively).


Patients receiving renal replacement therapy (HD and PD patients combined) were found to have a correlation between PTX3 and weekly erythropoietin dose and time on renal replacement therapy.


“The present study is the first description of PTX3 levels in patients with renal failure,” the investigators stated. “PTX3 plasma levels were significantly higher in HD patients compared with the other three groups. This difference is probably due to induction of PTX3 by the HD session.”