Prolactin and Inflammatory Cytokines in Hemodialysis Patients: A Cross-Sectional Study

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Background: Cardiovascular disease (CV) is the main cause of mortality in patients with chronic kidney disease. Non-traditional CV risk factors such as hyperphosphatemia, inflammation and microalbuminuria are important in these patients. Among these, hyperprolactinemia emerges as a potential non-traditional risk factor because it accumulates with loss of renal function and is associated with increased mortality. Initially described as a lactation hormone, today it is known that prolactin (PRL) has several actions, from pro-inflammatory effects to accelerated atherosclerosis. The aim of our study was to correlate serum levels of inflammatory cytokines in hemodialysis (HD) patients with normal and elevated PRL Methods: Single-center cross-sectional study evaluating all patients regularly enrolled in HD program in September 2019. Patients over the age of 18, on HD for at least 6 months, using an arteriovenous fistula for dialysis access were included. Those with active viral or bacterial infections, active cancer, inadequate KtV, use of medication or disease known to elevate PRL(hypothyroidism, chronic liver disease, macroadenoma), pregnant women and using immunosuppressants were excluded. Clinical, biochemicals and inflammatory cytokines [interleukin (IL)-2,-4,-6,-10,-17A, TNF-α and gamma interferon] were evaluated and compared between HD patients with elevated and normal PRL Results: Of the 360 regular HD patients, 249 were excluded: 110 temporary access, 87 active infection (viral or bacterial), 23 on drugs, 12 on immunosuppression, 5 cirrhosis, 4 inadequate KtV, 4 cancer, 3 less than 6 months on HD, 1 macroadenoma. Comparing data between patients with high(61) and normal(50) PRL, no statistical difference was seen in terms of age, sex, BMI, etiology, time on HD, cholesterol, albumin, calcium, phosphorus, PTH, glycated hemoglobin, hemoglobin, IL-2, IL-4, IL-17A, TNF-α,gIFN. There was a positive PRL correlation with serum levels of IL-6(p<0.0001,R=0.44); between PRL and IL-10, the correlation was negative and also statistically significant(p<0.046,R=0.2) Conclusions: HD patients with elevated PRL have been shown to have higher levels of IL-6 and lower levels of IL-10 Funding: Commercial Support - Siemens Healthcare Diagnósticos Ltda, Private Foundation SupportLaboratory parameters of patients with high and normal Prolactin

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