Akademik Veri Yönetim Sistemi
Medicine Science, cilt.15, sa.1, ss.523-531, 2026 (TRDizin)
Chronic inflammation and vitamin D deficiency are hallmarks of end-stage renal disease (ESRD), with potential links to fatigue through NF-κB-mediated pathways. However, the interrelationships among these factors in different dialysis modalities remain unclear. In this cross-sectional study, we enrolled 29 peritoneal dialysis (PD) and 29 hemodialysis (HD) patients, alongside 20 healthy controls. Measurements included serum 25-hydroxyvitamin D (25[OH]D), Nuclear Factor-kappa B (NF-κB), pro-inflammatory cytokines (IL-1β, IL-6, sIL-6R, IL-8, TNF-α), anti-inflammatory cytokines (IL-4, IL-10), and Short Form 36 (SF-36) quality of life assessments. Dialysis patients exhibited a pro-inflammatory state, characterized by significantly elevated levels of IL-6 (p=0.007), sIL-6R (p<0.001), and TNF-α (p=0.002) compared to controls. Conversely, IL-1β and IL-8 levels were lower, and anti-inflammatory IL-10 levels also tended to be lower in dialysis patients. NF-κB showed a positive correlation with TNF-α exclusively in HD patients (r=0.476, p=0.009). Vitamin D deficiency was profound in both groups (HD: 9.6±5.9 ng/mL; PD: 15.8±12.1 ng/mL). Despite these biochemical disturbances, no significant associations emerged between 25(OH)D, NF-κB levels, and fatigue scores. While PD patients reported better physical functioning (51.5±29.8 vs 33.6±30.2, p=0.027), both modalities showed marked vitality impairments (42.0±23.9 PD, 32.8±18.9 HD) compared to population norms (60.9±20.9). The study confirms a predominance of pro-inflammatory over anti-inflammatory cytokines in dialysis patients, accompanied by severe vitamin D deficiency in both groups, particularly in HD patients. The absence of a clear vitamin D-NF-κB-fatigue relationship may reflect the widespread deficiency observed, potentially obscuring biological effects. These findings highlight the need for interventional trials to evaluate whether vitamin D repletion to achieve sufficient levels can modify inflammatory profiles and alleviate fatigue symptoms in this patient population.