In peritoneal and hemodialysis patients the relationship among serum 25(OH) D and NF-κB and fatigue syndrom

ABSTRACT In patients with chronic renal failure vitamin D deficiency increases inflamation. NF-κB is a family of transcription factors that functions as a master regulator of immune response. In vitamin D deficiency leads to NF-B activation and chronic inflammation and chronic fatigue. In our study we aimed to compare levels of 25(OH) D and NF KB, proinflammatory cytokines (IL-1β, IL-6, sIL-6R, IL-8, TNF-α) and antiinflammatory cytokines (IL-4 ve IL-10) and life quality, fatigue symptoms in hemodialysis and peritoneal dialysis patients and evaluate the relationship among fatigue symptoms and serum 25 (OH) D and NF-B levels. In our study 78 patients (29 Continuous ambulatory peritoneal dialysis patients [16 male, 13 female], 29 hemodialysis patients [15 male,14 female]) and 20 age matched healthy controls [10 male,10 female] were included. We used Short Form 36 (SF 36) to evaluate fatigue symtoms in dailysis patients. We took vitality scores of SF 36 as predictors of fatigue symptoms. 49 Except IL-8 and IL-1β, levels of all proinflammatory cytokines were higher in both hemodialysis and peritoneal dialysis patients compred to those of controls. As a antiinflammatory cytokines IL10 levels were lower in both hemodialysis and peritoneal dialysis patients compred to those of controls. This indicates that dialysis patients, there is an imbalance that favors a proinflammatory state. In our study we found vitality scores of SF as 36 42,0±23,9 in peritoneal dialysis patients and 32,8±18,9 in hemodialysis patients and these results was below a community-based average score. In our study in neither hemodialysis nor peritoneal dialysis patients we detected a relationship between serum 25(OH)D levels and vitality scores of SF 36. In both hemodialysis patients and hemodialysis patients NF-B and serum 25(OH)D levels was not correlated. However, there was severe vitamin D deficiency in our study group. In peritoneal dialysis patients serum 25 (OH)D levels was 15,8±12,1 ng/ml, and 9,6±5,9 ng/ml in hemodialysis patients (p 0.05). As a conclusion both hemodialysis and peritoneal dialysis patients there is an imbalance that favors a proinflammatory state. In hemodialysis and peritoneal dialysis patients fatigue symptoms and vitamin D deficiency is very common. Eventhough we could not show any relationship among serum NF-B, 25 (OH) D levels and fatigue symptoms a similar study performing in big groups and including more patients with vitamin sufficient might find different results.