Induction of Tumor Necrosis Factor during Extracorporeal Blood Purification

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To the Editor: Recent studies have shown that blood monocytes become activated during regular hemodialysis and produce interleukin-1.1 2 3 Monocyte products such as interleukin-1 are thought to contribute to both the short-term and long-term changes that are observed with hemodialysis and, to a lesser extent, with hemofiltration.4 We now describe a patient who became acutely ill during a hemofiltration procedure that was associated with a markedly elevated plasma level of tumor necrosis factor.A 21-year-old woman with end-stage renal disease due to interstitial nephritis had received over 650 uneventful treatments using post-dilutional hemofiltration over the previous five years. Two weeks earlier, . . .

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