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Vol. 23, No. 4, 2005
Issue release date: 2005
Section title: Original Paper
Blood Purif 2005;23:311–316
(DOI:10.1159/000086554)

Ultrapure Dialysate Reduces Plasma Levels of β2-Microglobulin and Pentosidine in Hemodialysis Patients

Furuya R. · Kumagai H. · Takahashi M. · Sano K. · Hishida A.
aRenal Division, Department of Internal Medicine, Iwata City Hospital, Iwata; bDepartment of Clinical Nutrition, School of Food and Nutritional Sciences, University of Shizuoka, Shizuoka, and cDepartment of Orthopedic Surgery and dFirst Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 1/5/2005
Accepted: 4/14/2005
Published online: 10/4/2005
Issue release date: 2005

Number of Print Pages: 6
Number of Figures: 1
Number of Tables: 2

ISSN: 0253-5068 (Print)
eISSN: 1421-9735 (Online)

For additional information: http://www.karger.com/BPU

Abstract

Background: β2-Microglobulin (β2MG) and carbonyl stress are reported to contribute to the development of dialysis-related amyloidosis. The aim of this study was to determine whether the purity of dialysate affects plasma levels of β2MG and pentosidine (a surrogate marker of carbonyl stress) in hemodialysis patients. Methods: Sixteen patients on hemodialysis with a polysulfone membrane participated in this study. We switched the dialysate from conventional dialysate (endotoxin level 0.055–0.066 endotoxin units (EU)/ml) to ultrapure dialysate (endotoxin level <0.001 EU/ml), followed patients for 6 months, and then switched back to conventional dialysate once again. Plasma levels of β2MG, pentosidine, CRP and interleukin-6 (IL-6) were determined before the switch to ultrapure dialysate, 1 and 6 months after the switch to ultrapure dialysate, and 1 month after the switch back to conventional dialysate. Results: The switch from conventional to ultrapure dialysate significantly decreased plasma levels of β2MG, from 30.1 ± 1.4 to 27.1 ± 1.4 mg/dl (p < 0.05) and pentosidine, from 1,535.8 ± 107.5 to 1,267.6 ± 102.9 nmol/l (p < 0.01) after 1 month of use. The change of dialysate also significantly decreased plasma levels of CRP, from 0.28 ± 0.09 to 0.14 ± 0.05 mg/dl (p < 0.05) and IL-6, from 9.4 ± 2.7 to 3.5 ± 0.8 pg/ml (p < 0.01) over the 1-month period. These changes in plasma levels of β2MG, pentosidine, CRP and IL-6 were maintained over 6 months after switching to ultrapure dialysate and returned to basal levels by switching back to a conventional dialysate. Conclusions: Ultrapure dialysate decreases plasma levels of β2MG, pentosidine and inflammatory markers in hemodialysis patients. The use of ultrapure dialysate might be useful in preventing and/or treating complications of dialysis, such as dialysis-related amyloidosis, atherosclerosis and malnutrition.


  

Author Contacts

Ryuichi Furuya, MD, PhD
Renal Division, Department of Internal Medicine
Iwata City Hospital, 512-3 Ohkubo
Iwata 438-8550 (Japan)
Tel. +81 538 385000, Fax +81 538 385053, E-Mail r-furuya@isis.ocn.ne.jp

  

Article Information

Received: January 5, 2005
Accepted: April 14, 2005
Published online: June 23, 2005
Number of Print Pages : 6
Number of Figures : 1, Number of Tables : 2, Number of References : 33

  

Publication Details

Blood Purification

Vol. 23, No. 4, Year 2005 (Cover Date: 2005)

Journal Editor: Leunissen, K.M.L. (Maastricht)
ISSN: 0253–5068 (print), 1421–9735 (Online)

For additional information: http://www.karger.com/bpu


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 1/5/2005
Accepted: 4/14/2005
Published online: 10/4/2005
Issue release date: 2005

Number of Print Pages: 6
Number of Figures: 1
Number of Tables: 2

ISSN: 0253-5068 (Print)
eISSN: 1421-9735 (Online)

For additional information: http://www.karger.com/BPU


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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