Intercellular Adhesion molecule-1 and Neutrophil Extracellular Traps in children on maintenance hemodialysis: Evidence of a chronic inflammatory state

Said, Ragia Marei; Kasem, Mohammed Faheem; Mohamed, Noha Refaat; Hashem, Noha Usama

doi:10.21608/ejpa.2025.376894.1089

Intercellular Adhesion molecule-1 and Neutrophil Extracellular Traps in children on maintenance hemodialysis: Evidence of a chronic inflammatory state

Document Type : Original Article

Authors

¹ Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, Ain Shams University

² Department of Clinical Pathology, Faculty of Medicine, Ain Shams University

10.21608/ejpa.2025.376894.1089

Abstract

Background: Intercellular adhesion molecule-1 (ICAM-1) plays a key role in guiding leukocytes to sites of inflammation. Neutrophil extracellular traps (NETs) have been linked to vascular inflammation and blockages in patients with chronic kidney disease (CKD). The objective of this study was to measure serum levels of ICAM-1 and NETs both before and after a single session of high flux hemodialysis (HFHD) in children on maintenance hemodialysis. Methods: A total of 26 children who had been on HFHD for at least three months were enrolled, along with an equal number of healthy children matched for age and sex as controls. Patients with active inflammation, infections, or other relevant comorbid conditions were excluded from the study. Blood samples were collected from the patients both before and after their mid-week dialysis session to analyze complete blood counts (CBC), C-reactive protein (CRP), ICAM-1, and NETs levels. The same investigations were done for controls. Results: After the dialysis session, ICAM-1 and NETs levels showed a significant decrease compared to pre-dialysis measurements (p=0.000, p<0.0001 respectively). Despite this reduction, post-dialysis ICAM-1 and NETs levels remained higher than those observed in healthy controls (p=0.003, p=0.033, respectively). Conclusion: The findings support that end-stage kidney disease (ESKD) is characterized by ongoing inflammation. Unlike traditional views that suggest dialysis may add to the inflammatory process, our results indicate that effective hemodialysis can reduce inflammatory markers. Better dialysis membranes and novel modalities of dialysis should be tested to ensure they can exert a positive role in ameliorating this inflammatory status.

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