The impact of dialysis modality on serum heat shock proteins in children and young adults with chronic kidney disease.

BACKGROUND/AIMS: The acceleration of atherosclerosis by dialysis is not completely understood. The elevated levels of heat shock proteins (HSP) and antibodies against them were described in adults with atherosclerotic lesions, but there are no investigations on them in dialyzed patients. The aim of the study was to evaluate the serum HSP, their connections with dialysis modality and their possible role as markers of atherosclerosis.

METHODS

Hsp60, Hsp90-alpha, anti-Hsp60 and anti-Hsp70 concentrations were assessed by ELISA in 19 children on automated peritoneal dialysis (APD) and 17 patients on hemodialysis (HD). hsCRP, sE-selectin, IL-4, IL-12 and the lipid profile were also estimated.

RESULTS

Hsp60 values were lower, whereas Hsp90-alpha was higher in the dialyzed children than in the controls, without any difference between the dialysis modalities. The anti-Hsp60 concentrations were increased in all patients and higher in HD patients than in APD patients. The anti-Hsp70 levels in the APD children were decreased versus controls. Anti-Hsp60 correlated with HDL-cholesterol in APD children, and with total cholesterol and LDL-cholesterol in HD patients. Anti-Hsp70 correlated with sE-selectin in HD subjects.

CONCLUSIONS

The levels of antibodies against HSP seem to distinguish between the dialysis modalities and the correlations with the lipid profile and sE-selectin, suggesting their potential role as markers of atherosclerosis.