Soluble adhesion molecules in children and young adults with chronic renal failure treated conservatively.

PURPOSE Chronic renal failure (CRF) patients present with signs of immunodeficiency, such as increased incidence of infections. Cell adhesion molecules, determining leukocyte migration, may be responsible for the impaired immune response. The aim of the study was to measure soluble (s) vascular cell adhesion molecule-1 (VCAM-1), intercellular cell adhesion molecule-1 (ICAM-1), P-selectin and L-selectin levels in sera of CRF children and young adults. MATERIAL AND METHODS The evaluation of adhesion molecule concentrations by ELISA was performed on 15 patients with serum creatinine levels below 265.2 micromol/l (gr. I), 15 patients with serum creatinine levels above 265.2 micromol/l (gr. II) and 15 controls. RESULTS sVCAM-1, sICAM-1 and sP-selectin concentrations were elevated in both groups vs controls, whereas sL-selectin levels were decreased in all CRF patients. Mean sVCAM-1 and sICAM-1 values in gr. I and gr. II were comparable. sL-selectin and sP-selectin mean values in gr. II were lower than in gr. I. sICAM-1 correlated with haemoglobin and erythrocyte count in both groups and with haematocrit and serum urea--in gr. I. CONCLUSIONS Enhanced (sVCAM-1, sICAM-1, sP-selectin) and diminished (sL-selectin) adhesion molecule concentrations in both groups show a state of immunologic imbalance, already present in early stages of CRF. Differences in sL-selectin concentrations between gr. I and II imply a progressive character of CRF-related leukocyte dysfunction. sICAM-1 correlation with anaemia markers may suggest the connection between this molecule and the CRF-related disorders.