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Effects of Dialysis Purity on Uremic Dyslipidemia
Author(s) -
Schiffl Helmut,
Lang Susanne M
Publication year - 2010
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/j.1744-9987.2009.00713.x
Subject(s) - dyslipidemia , medicine , oxidative stress , hemodialysis , dialysis , endocrinology , uremia , kidney disease , lipid profile , cholesterol , diabetes mellitus
Dyslipidemia, a prominent feature of end‐stage renal disease, is considered a risk factor for premature atherosclerosis in hemodialysis (HD) patients. Dyslipidemia is related to loss of kidney function as well as use of low‐flux cellulosic dialyzer membranes, but the effects of dialysate purity are unknown. Forty‐eight incident HD patients started high‐flux polysulfone maintenance HD, either with conventional (potentially contaminated) or with on‐line produced ultrapure dialysate. The quality of the dialysis fluid (CFU/mL, endotoxin concentration), markers of inflammation (C‐reactive protein, Il‐6), and parameters of the lipid profile and oxidative stress (oxidized low‐density lipoprotein) were measured before initiation of HD, and after 6, 12 and 24 months on HD. Compared to baseline, treatment with conventional (mildly contaminated) dialysate significantly increased the uremic low‐grade systemic inflammatory response syndrome (SIRS), augmented uremic dyslipidemia (triglycerides by +21%, and high‐density lipoprotein (HDL) cholesterol by −10%) and enhanced oxidative stress. In contrast, the use of ultrapure dialysate significantly decreased uremia‐associated SIRS, dyslipidemia (triglycerides −7% and HDL cholesterol +11%) and oxidative stress. Ultrapure dialysis fluid improves potential parameters of cardiovascular risk by decreasing inflammatory reactions, improving uremic dyslipidemia and lowering oxidative stress.