Skip to main content

Advertisement

SpringerLink
Log in

Modulation of the immune response to HBV vaccination by hemodialysis membranes

  • Nephrology - Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Introduction

Seroconversion response to Hepatitis B virus (HBV) vaccination is limited in uremic patients because of impaired humoral and cellular immune activity. Recent studies show that high-flux (HF) hemodialysis (HD) membranes can improve T cell functions and decrease the proinflammatory cytokine activation more effectively than low-flux (LF) membranes. In regard to HF membranes may have immune modulator effects; we compared the antibody responses to hepatitis B vaccination between HF HD and LF HD membranes.

Methods

One thousand four hundred and eight patients on HD programmed for 4 h three times a week at three different centers with HF or LF membranes were scanned. Anti-HBs levels of these patients who were vaccinated with recombinant DNA HBV vaccine on the 0, 1st, 2nd and 6th month from the beginning were recorded on the 0, 3rd, 6th, 9th and 12th month of vaccination schedule.

Results

Seroconversion rate was 84.2% in HF group and 52.7% in LF group on the 6th month (P < 0.01). Ratio of the patients who had >100 IU/l antibody titers in HF group was 22.8%, while it was 10.9% in LF group (P < 0.01). Also on the 9th, 12th and 24th month; seroconversion rates in HF group were higher than LF group: 91.1–70.9% (P < 0.05), 95.0–81.8% (P < 0.05), 92.1–83.7% (P > 0.05), respectively. Ratio of the patients who did not show any seroconversion was higher in LF group than HF group; on the 6th month as 15.8–47.3% (P < 0.001), on the 9th month 8.9–29.1% (P < 0.05), on the 12th month as 5.0–18.2% (P < 0.05), and on the 24th month as 7.9–16.4% (P > 0.05), respectively.

Conclusion

We showed that ratio of anti-HBs seroconversion response to hepatitis B vaccination in patients receiving HD with HF membranes was higher than LF membranes. This finding suggests that HF membranes may improve immune modulator effects.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Fabrizi F, Martin P, Dixit V, Bunnapradist S, Dulai G (2004) Meta-analysis: the effect of age on immunological response to hepatitis B vaccine in end-stage renal disease. Aliment Pharmacol Ther 20:1053–1062

    Article  CAS  PubMed  Google Scholar 

  2. Tsouchnikas I, Dounousi E, Xanthopolou K, Papakostantinou S, Thomoglou V, Tsakiris D (2007) Loss of hepatitis B immunity in hemodialysis patients acquired either naturally or after vaccination. Clin nephrol 68(4):228–234

    CAS  PubMed  Google Scholar 

  3. Stevens CE, Alter HJ, Taylor PE et al (1984) Hepatitis B vaccine in patients receiving hemodialysis. Immunogenicity and efficacy. N Engl J Med 311:496

    Article  CAS  PubMed  Google Scholar 

  4. Buti M, Viladomiu L, Jardi R et al (1992) Long-term immunogenicity and efficacy of hepatitis B vaccine in hemodialysis patients. Am J Nephrol 12:144

    Article  CAS  PubMed  Google Scholar 

  5. Fabrizi F, Martin P (2001) Hepatitis B vaccine and dialysis: current issues. Int J Artif Organs 24:683–694

    CAS  PubMed  Google Scholar 

  6. Cheung AK, Levin NW, Greene T, Agodoa L, Bailey J, Beck G, Clark W, Levey AS, Leypoldt JK, Ornt DB, Rocco MV, Schulman G, Schwab S, Teehan B, Eknoyan G, for the HEMO Study Group (2003) Effect of high-flux hemodialysis on clinical outcomes: results of the HEMO Study. J Am Soc Nephrol 14:3251–3263

    Google Scholar 

  7. Lonneman G, Novick D, Rubinstein M, Passlick-Deetjen J, Lang D, Dinarello CA (2003) A switch to high-flux helixone membranes reverses suppresed interferon gamma production in patients on low-flux dialysis. Blood Purif 21:225–231

    Article  Google Scholar 

  8. Bordoni V, Piroddi M, Galli F et al (2006) Oxidant and carbonyl stres-related apoptosis in end-stage kidney disease: impact of membrane flux. Blood Purif 24:149–156

    Article  PubMed  Google Scholar 

  9. Daugirdas JT (1995) Simplified equations for monitoring Kt/V, PCRn, eKt/V, and ePCRn. Adv Ren Replace Ther 2(4):295–304

    CAS  PubMed  Google Scholar 

  10. Grzegorzewska AE, Banachowicz W (2008) Evaluation of hemodialysis adequacy using online Kt/V and single-pool variable-volume urea Kt/V. Int Urol Nephrol 40(3):771–778

    Article  PubMed  Google Scholar 

  11. Verkade MA, van Druningen CJ, Op de Hoek CT, Weimar W, Betjes MG (2007) Decreased antigen-spesific T-cell proliferation by moDC among hepatitis B vaccine non-responders on hemodialysis. Clin Exp Med 7:65–71

    Article  CAS  PubMed  Google Scholar 

  12. Girndt M, Köhler H (2002) Hepatitis B virus infection in hemodialysis patients. Semin Nephrol 22(4):340–350

    CAS  PubMed  Google Scholar 

  13. Stachowski J, Pollok M, Barth C, Maciejewski J, Baldamus CA (1994) Non-responsiveness to hepatitis B vaccination in haemodialysis patients: association with impaired TCR/CD3 antigen receptor expression regulating co-stimulatory processes in antigen presentation and recognition. Nephrol Dial Transplant 9:144–152

    CAS  PubMed  Google Scholar 

  14. Girndt M, Kohler H, Schiedelm-Weick E, Schlaek J, Meyer Zum Buschenfelde KH, Fleicher B (1995) Production of interleukin-6, tumor necrosis factor and interleukin-10 in vitro correlates with the clinical immune defect in chronic hemodialysis patients. Kidney Int 47:559–565

    Article  CAS  PubMed  Google Scholar 

  15. Descamps-Latscha B, Chatenoud L (1996) T cells and B cells in chronic renal failure. Semin Nephrol 16:183–191

    CAS  PubMed  Google Scholar 

  16. Caillat ZS, Gimenez JJ, Wambergue F (1998) Distinct HLA class II alleles determine to antibody response to vaccination with hepatitis B surface antigen. Kidney Int 53:1626–1630

    Article  Google Scholar 

  17. Cheung AK, Rocco MV, Yan G et al (2006) Serum beta-2 microglobulin levels predict mortality in dialysis patients: results of the HEMO study. J Am Soc Nephrol 17(2):546–555

    Article  CAS  PubMed  Google Scholar 

  18. Vanholder R, Ringoir S, Dhondt A, Hakim R (1991) Phagocytosis in uremic and hemodialysis patients: a prospective and cross sectional study. Kidney Int 39:320–327

    Article  CAS  PubMed  Google Scholar 

  19. Ward RA, Ouseph R, McLeish KR (2003) Effect of high-flux hemodialysis on oxidant stress. Kidney Int 63:353–369

    Article  PubMed  Google Scholar 

  20. Girndt M, Heisel O, Köhler H (1999) Influence of dialysis with polyamide versus hemophane hemodialysis on monokines and complement activation during a four month long term study. Nephrol Dial Transplant 14:676–682

    Article  CAS  PubMed  Google Scholar 

  21. Schindler R, Lonnemann G, Schaffer J (1994) The effect of ultrafiltered dialysate on the cellular content of interleukin-1 receptor antagonist in patients on chronic hemodialysis. Nephron 68:229–233

    Article  CAS  PubMed  Google Scholar 

  22. Schiffl H, Wendinger H, Lang SM (2002) Ultrapure dialysis fluid and response to hepatitis B vaccine. Nephron 91:530–531

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Nephrology, Ankara Numune Training and Research Hospital, Samanpazari/Ankara, 06530, Turkey

    Fatih Dede, Deniz Aylı, Ali Rıza Odabaş & Hadim Akoğlu

  2. Department of Internal Medicine, Ankara Numune Training and Research Hospital, Ankara, Turkey

    Ayla Yıldız, Nujen Çolak & Erdal Eskioğlu

  3. Department of Nephrology Clinic and Dialysis and Transplantation Center, ‘‘C. I. PARHON’’ University Hospital, Lasi, Romania

    Adrian Covic

Authors
  1. Fatih Dede
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ayla Yıldız
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Deniz Aylı
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nujen Çolak
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ali Rıza Odabaş
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hadim Akoğlu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Erdal Eskioğlu
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Adrian Covic
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Fatih Dede.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dede, F., Yıldız, A., Aylı, D. et al. Modulation of the immune response to HBV vaccination by hemodialysis membranes. Int Urol Nephrol 42, 1069–1075 (2010). https://doi.org/10.1007/s11255-009-9616-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-009-9616-z

Keywords

Search

Navigation