Serum Resistin Level and Polymorphonuclear Leukocytes Dysfunctions in Children on Regular Hemodialysis

Abstract

Resistin is a secretory adipocytoine, which is expressed mainly in humans by inflammatory cells especially macrophages. Resistin serum levels are elevated in end-stage renal diseases of people having an increased risk of infections as a result of impaired polymorphonuclear leukocytes (PMNLs) functions. Objectives: To evaluate neutrophil functions (phagocytosis and oxidative burst) in children with end-stage renal disease (ESRD) on regular hemodialysis and to shed light on the contribution of resistin on neutrophil functions. Patients and Methods: The study included 40 children with ESRD on regular hemodialysis. Their ages ranged from 6 to 12 years, and they were selected from children attending the pediatric hemodialysis unit of AL-Zahraa Hospital, Al-Azher University during the period from October 2012 to December 2013. Another group of 40 apparently healthy children with matched age and sex with the patient group served as a control. Serum resistin, phagocytic index and nitro blue tetrazolium test (NBT%) were assessed in both groups. Results: There was a statistically more significant increase in resistin serum levels in cases than in controls; it was (3.25 ± 0.86 ng/ml) and (0.25 ± 0.16 ng/ml) respectively (P < 0.01). On the other hand there was a statistically more significant decrease in neutrophil phagocytic index in cases than in controls; it was (2.57 ± 1.34) and (3.55 ± 0.74) respectively (P < 0.01). Also it showed a statistically more significant decrease in NBT% in cases than in controls; it was (47.98 ± 16.38%) and (61.45 ± 13.17%) respectively (P < 0.01). We found negative correlation between resistin serum level with phagocytic index and NBT%, while we found positive correlation between resistin serum level and hemodialysis duration. Conclusion: High resistin serum level in children with ESRD decreases phagocyte function and oxidative burst of PMNLs, and this is enhanced by the longer duration of hemodialysis.