ABSTRACT
Patients with end-stage renal disease are at a high risk of hepatitis C virus [HCV] infections. These patients are on maintenance hemodialysis where they are exposed to dialysis fluid and dialysis membrane that generate an acute-phase response, which leads to inflammation, reflected in increased inflammatory markers like C-reactive protein [CRP] and interleukin-6 [IL-6]. The aim of this study was to investigate levels of IL-6 and CRP in patients on hemodialysis and to determine effects of HCV on these markers. A total of 43 patients [39.5% men and 60.5% women; age range, 21 to 65 years] on maintenance hemodialysis for a period of at least 3 months were included. Twenty-four of them were HCV positive. Serum IL-6 and CRP were assessed in all patients. Of HCV-positive patients, 11 [45.8%] had high levels of CRP, while 13 [54.2%] had low levels and increased levels of IL-6 [1064 +/- 544.2 pg/mL, P=.19]. Of 19 HCV-negative patients, 13 [68.4%] had high levels of CRP, while 6 [31.6%] had low levels, and all these patients had low levels of IL-6, as compared to HCVpositive patients. No significant correlation was observed between the levels of CRP or IL-6 and the duration of dialysis. In our study, we found high serum IL-6 and CRP levels in HCV-positive hemodialysis patients, compared with HCVnegative ones. However, we failed to show the significance of these differences. More studies with large sample sizes and evaluation of the other inflammatory markers are warranted
ABSTRACT
Aim of the study was to determine the frequency of antineutrophil cytoplasmic antibody [ANCA] [p-ANCA and c-ANCA] in clinically diagnosed glomerulonephritis. Autoimmune diseases including systemic vasculitis, affect a large number of people ill whom the leading cause of morbidity and mortality is glomerulonephritis that is often associated with chronic kidney disease. There are many risk factors for kidney diseases such as chronic inflammation, auto-immune diseases, immunosuppressive therapy, etc. Early phases of renal injury in autoimmune patients are clinically silent. For the detection of nephron damage, histopathological examination is gold standard but detection of antineutrophil cytoplasmic antibody [ANCA] can be used to find out early nephron damage. Design was analytical Cross-sectional. The study was conducted at the Department of Immunology, University of Health Sciences, Lahore in a period of November 2008 to October 2009. Study included 64 clinically diagnosed of glomerulonephritis. Levels of ANCA [MPO and PR3] were determined by ELISA technique. Out of which four [6.25%] patients showed positive reaction to myeloperoxidase [MPO] antigen while1 [1.56%] patient was positive for proteinase-3 [PR3] antigen. In 40-60 years of patients, sero-positivity for MPO and PR3 was 14% and 3.6% respectively, p-value for MPO and PR3 was <0.05 and >0.05 respectively. We concluded that glomerulonephritis is better related with MPO-ANCA than PR3-ANCA. The difference in the levels of MPO-ANCA in different age groups was significant but it was non-significant among different genders. Difference in the levels of PR3-ANCA was not significant for both age and gender