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Original Paper

Ultrapure Dialysis Fluid Lowers the Cardiovascular Morbidity in Patients on Maintenance Hemodialysis by Reducing Continuous Microinflammation

Lederer S.R. · Schiffl H.

Author affiliations

Kuratorium für Dialyse und Nierentransplantation, Dialysezentrum München-Laim, München, Deutschland

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Nephron 2002;91:452–455

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: July 01, 2002
Issue release date: July 2002

Number of Print Pages: 4
Number of Figures: 1
Number of Tables: 3

ISSN: 1660-8151 (Print)
eISSN: 2235-3186 (Online)

For additional information: https://www.karger.com/NEF

Abstract

The aims of our prospective 3-year investigation were (1) to clarify whether high C-reactive protein (CRP) levels are an intermittent or a continuous phenomenon in individual hemodialysis patients and (2) to evaluate a possible relationship between ultrapure dialysis fluid associated CRP levels and an increased prevalence of atherosclerosis in a group of 60 hemodialysis patients treated either with conventional (n = 38) or on-line-produced ultrapure dialysis fluid (n = 22). Primary end points of the study were angiographically confirmed cerebrovascular, cardiovascular, or peripheral vascular events. Measurements of the CRP levels were done every 3 months using a highly sensitive assay. The CRP levels were normal (<0.5 mg/dl) in 45 patients and raised in 15 patients at the time of recruitment. In 87% of the patients with normal CRP levels, ultrapure dialysis fluid was used. The CRP levels measured at recruitment and at various time points thereafter did not differ significantly within patient groups. However, patients with increased CRP concentrations experienced significantly more vascular events as compared with patients with normal CRP levels (11 events vs. 1 event; p < 0.001). The data indicate that continuous induction of acute-phase proteins represents a nontraditional vascular risk factor contributing to the development and progression of atherosclerosis in dialysis patients. Ultrapure dialysis fluid lowers cardiovascular morbidity by preventing/reducing chronic microinflammation.

© 2002 S. Karger AG, Basel


References

  1. Iseki K, Tozawa M, Yoshi S, Fukiyama K: Serum C-reactive protein (CRP) and risk of death in chronic dialysis patients. Nephrol Dial Transplant 1999;14:1956–1960.
  2. Zimmermann J, Herrlinger S, Pruy A, Metzger T, Wanner C: Inflammation enhances cardiovascular risk and mortality in hemodialysis patients. Kidney Int 1999;55:648–658.
  3. Bologa RM, Levine DM, Parker TS, Cheigh JS, Serur D, Stenzel KH, Rubin AL: Interleukin-6 predicts hypoalbuminemia, hypocholesterolemia, and mortality in hemodialysis patients. Am J Kidney Dis 1998;32:107–114.
  4. Panichi V, Migliori M, De Pietro S, Taccola D, Bianchi AM, Norpoth M, Giovannini L, Palla R, Tetta C: C-reactive protein as marker of chronic inflammation in uremic patients. Blood Purif 2000;18:183–190.
  5. Bergström J, Lindholm B, Lacson E, Owen W, Lowrie EG, Glassock RJ, Ikizler TA, Wessels FJ, Moldawer LL, Wanner C, Zimmermann J: What are the causes and consequences of the chronic inflammatory state in chronic dialysis patients? Semin Dial 2000;13:163–175.
    External Resources
  6. Kaysen GA, Dubin JA, Muller HG, Rosales LM, Levin NW: The acute-phase response varies with time and predicts serum albumin levels in hemodialysis patients. The HEMO Study Group. Kidney Int 2000;58:346–352.
    External Resources
  7. Stenvinkel P, Heimburger O, Jogestrand T, Karnell A, Samuelsson A: Does persistent infection with Chlamydia pneumonia increase the risk of atherosclerosis in chronic renal failure? Kidney Int 1999;55:2531–2532.
  8. Stenvinkel P: Malnutrition and chronic inflammation as risk factors for cardiovascular disease in chronic renal failure. Blood Purif 2001;19:143–151.
  9. Schindler R, Boenisch O, Fischer C, Frei U: Effect of the hemodialysis membrane on the inflammatory reaction in vivo. Clin Nephrol 2000;53:452–459.
  10. Sitter T, Bergner A, Schiffl H: Dialysate related cytokine induction and response to recombinant human erythropoietin in haemodialysis patients. Nephrol Dial Transplant 2000;15:1207–1211.
    External Resources
  11. Arici M, Walls J: End-stage renal disease, atherosclerosis, and cardiovascular mortality: Is C-reactive protein the missing link? Kidney Int 2001;59:407–414.
    External Resources
  12. Lonnemann G: Chronic inflammation in hemodialysis: The role of contaminated dialysate. Blood Purif 2000;18:214–223.
  13. Ridker PM, Rifai N, Pfeffer MA, Sacks F, Braunwald E: Long-term effects of pravastatin on plasma concentration of C-reactive protein. The Cholesterol and Recurrent Events (CARE) Investigators. Circulation 1999;100:230–235.
  14. Jialal I, Stein D, Balis D, Grundy SM, Adams-Huet B, Devaraj S: Effect of hydroxymethyl glutaryl coenzyme A reductase inhibitor therapy on high sensitive C-reactive protein levels. Circulation 2001;103:1933–1935.
  15. Yeun JY, Levine RA, Mantadilok V, Kaysen GA: C-reactive protein predicts all-cause and cardiovascular mortality in hemodialysis patients. Am J Kidney Dis 2000;35:469–476.

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: July 01, 2002
Issue release date: July 2002

Number of Print Pages: 4
Number of Figures: 1
Number of Tables: 3

ISSN: 1660-8151 (Print)
eISSN: 2235-3186 (Online)

For additional information: https://www.karger.com/NEF


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