© 2015 Wichg Publishing JVA ISSN 1129-7298 J Vasc Access 2015; 16 (5): 377-381 ORIGINAL ARTICLE with minimal complicaons. Tunneled permanent catheters (TPCs) are being increasingly used for VA. These chronic in- dwelling devices may be an unrecognized source of chronic inflammaon in HD paents. High sensive C-reacve protein (hs-CRP), the main acute phase protein, and high hs-CRP levels indicate persistent in- flammaon and predict overall mortality in CKD paents (4, 5). Although there is a strong correlaon between increased hs- CRP levels and TPC in HD paents (6-8), hs-CRP is not an ideal marker to assess inflammatory reacons during HD because of its delay in response to smuli and its large intra-individual and inter-individual variability (9). Pentraxin 3 (PTX3) is a recently discovered acute phase protein. It is rapidly produced by different cell types, parcu- larly mononuclear phagocytes, dendric cells, fibroblasts and endothelial cells in response to proinflammatory signals by smuli, including bacterial products, interleukin-1β and tumor necrosis factor-α (TNF-α) (10-15). Prior studies have demonstrated that PTX3 is a reliable and rapidly responsive inflammatory marker (16, 17). PTX3 levels are elevated in CKD and HD paents and increased PTX3 levels were asso- ciated with increased mortality and cardiovascular disease (18, 19). DOI: 10.5301/jva.5000409 Relaonships between plasma pentraxin 3 levels and inflammaon markers paents with tunneled permanent catheter in hemodialysis Irem Pembegul Yigit 1 , Ayhan Dogukan 2 , Hulya Taskapan 3 , Melda Comert 4 , Necip Ilhan 5 , Ramazan Ulu 2 , Bilge Aygen 2 1 Department of Nephrology, Malatya Government Hospital, Malatya - Turkey 2 Department of Nephrology, Faculty of Medicine, Firat University, Elazig - Turkey 3 Department of Nephrology, Faculty of Medicine, Inonu University, Malatya - Turkey 4 Department of Hematology, Faculty of Medicine, Ege University, Izmir - Turkey 5 Department of Biochemistry, Faculty of Medicine, Firat University, Elazig - Turkey Introducon Inflammaon increases with progression of chronic kid- ney disease (CKD) and aſter the start of renal replacement therapy, especially during hemodialysis (HD) (1). Chronic in- flammaon contributes to malnutrion, atherosclerosis and cardiovascular disease (2). Inflammaon in HD paents may be related to vascular access (VA), genec factors, dialysate quality, bioincompable membranes, comorbid condions, decreased anoxidants, low solute clearance and increased producon of proinflammatory cytokines (3). The goal of chronic VA is to provide repeated access to the circulaon ABSTRACT Purpose: Vascular access (VA) devices may contribute to chronic inflammaon in hemodialysis (HD). Pentraxin 3 (PTX3) is a recently discovered acute phase protein that responds more rapidly than other inflammatory markers. This study compared PTX3 and other markers between HD paents and healthy controls. Methods: The study populaon included 30 paents with tunneled permanent catheter (TPC), 30 paents with arteriovenous fistula (AVF) and 30 healthy controls. Hemogram, biochemical assays, ferrin, high sensive C- reacve protein (hs-CRP), tumor necrosis factor-α (TNF-α) and PTX3 were evaluated in all groups. Results: PTX levels were highest in HD paents with TPC, intermediated in HD paents with AVF and lowest in healthy controls (5.2 + 2.4 vs. 3.1 + 1.3 vs. 1.8 + 0.7, p<0.001 for all comparisons). PTX3 levels correlated strongly to hs-CRP (r = 0.857) and moderately to TNF-α, NLR, ferrin and total neutrophil count. PTX3 and albumin levels had a negave correlaon. PTX3 levels were higher in paents with 8 months of TPC than those with 7 months or less. Conclusions: PTX3 levels are significantly elevated in all paents on HD, but presence and extended duraon of TPC are associated with incrementally higher levels of PTX3 and other inflammatory markers. PTX3 and NLR may be useful in assessing chronic inflammatory states in HD. Keywords: Arteriovenous fistula, Hemodialysis, Inflammaon, Pentraxin 3, Tunneled permanent catheter Accepted: April 8, 2015 Published online: June 12, 2015 Corresponding author: Irem Pembegul Yigit Department of Nephrology Malatya Government Hospital 44300 Malatya, Turkey pembegulmd@yahoo.com