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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Greaves, Ronda / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter

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CiteScore 2018: 2.44

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Volume 44, Issue 12


Increase in and clearance of cell-free plasma DNA in hemodialysis quantified by real-time PCR

Vanessa García Moreira
  • Servicio de Bioquímica Clínica, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Tamara de la Cera Martínez
  • Servicio de Bioquímica Clínica, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Emilio Gago González
  • Unidad de Hemodiálisis, Servicio de Nefrología I, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Belén Prieto García
  • Servicio de Bioquímica Clínica, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Francisco V. Alvarez Menéndez
  • Servicio de Bioquímica Clínica, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain and Departamento de Bioquímica y Biología Molecular, Universidad de Oviedo, Oviedo, Asturias, Spain
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2006-12-13 | DOI: https://doi.org/10.1515/CCLM.2006.252


Background: Recently cell-free plasma DNA has been described as a marker of apoptosis during hemodialysis (HD), but little is known about how different dialysis membranes may contribute to this process or whether pre-HD levels are restored afterwards. Here we evaluate the influence of the dialysis membrane on cell-free plasma DNA levels and investigate the clearance of plasma circulating DNA after HD.

Methods: Cell-free plasma DNA was measured using a real-time quantitative PCR for the β-globin gene. Reference values for plasma DNA were established in a group of 100 healthy voluntary blood donors. Pre- and post-HD levels were also measured in 30 patients with end-stage renal disease on regular HD (52 sessions; 104 samples). The sessions lasted for 2.5–5h. Different dialysis membranes were compared: high-flux (n=37) vs. low-flux (n=15) and polysulfone (n=42) vs. modified cellulose (n=10). To determine the time at which pre-HD levels are restored, DNA was quantified in serial plasma samples obtained from 10 of these 30 patients, just before and immediately after HD, as well as at 30, 60 and 120min after HD.

Results: Reference plasma DNA values for healthy blood donors ranged from 112 to 2452gEq/mL (median 740gEq/mL). Cell-free plasma DNA levels significantly increased during HD (Wilcoxon test for paired samples, p<0.0001), with increases of more than four-fold observed in 75% of the patients after HD. There was no significant linear association between the length of the HD session (between 2.5 and 5h) and the increase in cell-free plasma DNA concentration (Pearson correlation). No significant differences were observed between different types of membranes (Mann-Whitney U-test). Plasma DNA returned to pre-HD levels by 30min after HD, regardless of the starting concentration.

Conclusions: Plasma DNA levels significantly increase after a conventional 2.5–5-h HD session. Therefore, HD patients require special consideration for correct interpretation of plasma DNA concentrations. This parameter can be considered a reliable diagnostic tool for certain pathologies when measured at least 30min after a HD session without further complications. The different dialysis membranes used in this study had no influence on cell-free plasma DNA concentrations, so the level of circulating DNA is not an appropriate marker of dialysis membrane biocompatibility.

Clin Chem Lab Med 2006;44:1410–5.

Keywords: apoptosis; cell-free plasma DNA; circulating DNA; dialysis membrane; hemodialysis; real-time PCR; renal insufficiency


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About the article

Corresponding author: Francisco V. Alvarez Menéndez, Servicio de Bioquímica Clínica, Hospital Universitario Central de Asturias, 33006 Oviedo, Spain Phone/fax: +34-98-5108073,

Received: 2006-05-29

Accepted: 2006-08-29

Published Online: 2006-12-13

Published in Print: 2006-12-01

Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 44, Issue 12, Pages 1410–1415, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/CCLM.2006.252.

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