Assessment of inflow of endotoxin and its fragments in patients on maintenance hemodialysis.

Abstract:

BACKGROUND:We estimated the flow of endotoxins (ET) from dialysates into the blood of patients on hemodialysis (HD) using limulus amebocyte lysate (LAL) assays and endotoxin activity (EA) determined by neutrophil respiratory burst activity. METHODS:A cross-sectional study compared groups given ultrapure bicarbonate (n = 15; group A), acetate-free bicarbonate dialysates (n = 20; group B) and conventional bicarbonate dialysate (n = 23; group C). A prospective study of group C examined the effect of changing the purity of the dialysate. Biomarkers of inflammation and oxidative stress were measured and ET in blood was assessed by LAL assays and EA. RESULTS:Serum ET levels did not differ among the groups, whereas EA and the biomarkers were significantly increased in group C compared with those in groups A and B. HD using conventional dialysate was independently associated with an increase in EA. Purifying the dialysate significantly decreased EA in group C. CONCLUSION:Measuring EA is useful to assess the influence of dialysate contamination in HD patients.

journal_name

Blood Purif

journal_title

Blood purification

authors

Suzuki H,Honda H,Kato N,Michihata T,Takahashi K,Shishido K,Akizawa T

doi

10.1159/000322622

subject

Has Abstract

pub_date

2011-01-01 00:00:00

pages

268-75

issue

4

eissn

0253-5068

issn

1421-9735

pii

000322622

journal_volume

31

pub_type

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