Use of ultrapure dialysate in reduction of chronic inflammation during hemodialysis
Use of ultrapure dialysate in reduction of chronic inflammation during hemodialysis
复制标题
DOI：
10.1159/000081870
复制
发表时间：
2004-01-01
影响因子：
3
通讯作者：
Fukui, H
中科院分区：
文献类型：
--
作者：
Arizono, K;Nomura, K;Fukui, H
慢性炎症导致血液透析治疗的多种并发症的发病机制。据认为，透析过程中细菌源性污染物的反滤可能会诱发慢性炎症状态。高敏 C 反应蛋白 (hs-CRP) 是控制此类慢性炎症的工具之一。我们检查了超纯透析液对 hs-CRP 导致慢性炎症的影响，并尝试将透析液结束时的内毒素 (ET) 水平从 70 EU/l 降低至 < 1.0 EU/l（超纯透析液）。除 ET 水平外，其他透析条件均固定。我们前瞻性地调查了 23 名接受定期透析的患者在使用超纯透析液前和使用超纯透析液后 1 年后的 hs-CRP。数据显示 hs-CRP 中值从 0.16 mg/dl 显着下降至 0.07 mg/dl (p < 0.05)。血清 β(2)-微球蛋白值从 33.2 降至 28.4 mg/dl (p < 0.01)，血红蛋白水平从 10.0 g/dl 增加至 11.0 g/dl (p < 0.05)。这些结果表明，即使透析液含有 70 EU/l ET 水平也可能诱发慢性炎症状态。 hs-CRP 是一种非常有用的慢性炎症标志物，使用超纯透析液对于改善慢性炎症状态是必要的。透析液结束时的目标 ET 水平应设置为小于或等于 1.0 EU/l。版权所有 (C) 2004 S. Karger AG，巴塞尔。
Chronic inflammation contributes to the pathogenesis of several complications of hemodialysis therapy. It is thought that backfiltration of bacteria-derived contaminations during dialysis may induce a chronic inflammatory state. High-sensitivity C-reactive protein (hs-CRP) is one of the tools which can take a hold on such a chronic inflammatory condition. We examined the effect of ultra-pure dialysate which contributes to chronic inflammation with hs-CRP and tried to reduce endotoxin ( ET) levels at the end of the dialysate from 70 EU/l to < 1.0 EU/l (ultrapure dialysate). Other dialysis conditions, except ET level, were fixed. We investigated the hs-CRP of 23 patients receiving regular dialysis before the use of ultrapure dialysate and 1 year after use of it prospectively. The data showed a significant decrease in the median value of the hs-CRP from 0.16 to 0.07 mg/dl (p < 0.05). The value of serum beta(2)-microglobulin decreased from 33.2 to 28.4 mg/dl (p < 0.01) and the hemoglobin level increased from 10.0 to 11.0 g/dl (p < 0.05). These results indicate that even a dialysate containing 70 EU/l of ET level may induce a chronic inflammatory state. hs-CRP is a very useful marker of chronic inflammation and the use of ultrapure dialysate is necessary to improve a chronic inflammatory state. The targeted ET level at the end of the dialysate should be set at less than or equal to 1.0 EU/l. Copyright (C) 2004 S. Karger AG, Basel.