High level of soluble tumor necrosis factor receptors is a contributing factor of lower diuresis volume in hemodialysis patients: An exploratory study

Objective: The objective of this study was to explore the possible link between inflammatory parameters and diuresis volume in hemodialysis patients. Methods Blood samples were collected from sixty hemodialysis patients for the analysis of soluble receptors: 1) tumor necrosis factor (sTNFR1), 2) tumor necrosis factor (sTNFR2), and 3) leptin. Confounding variables, such as gender, age, duration of hemodialysis, Kt/v (a measure of dialysis adequacy), and body composition assessed using the gold standard method (i.e., dual-energy X-ray absorptiometry - DXA), were also systematically evaluated. Data analyses were conducted using both single and multiple regression models, adjusted for the confounding parameters. Results Of the total participants, 27 (45%) were classified as anuric, and 33 (55%) as non-anuric. A high sTNFR1 plasma level was associated with a lower volume of diuresis, irrespective of adjustments for confounding parameters (R2 = 25.4%; β = 0.504; p < 0.001). In conclusion: Our research supports the hypothesis that a high systemic sTNFR1 level may contribute to the reduced diuresis volume observed in hemodialysis patients.