Water purity and inflammation in hemodialyzed patients

作者：Fathy Shadia A^*; Abdel Hamid Fatma F; Tawfic Tarik A; Aly Amira M

来源：Kuwait Journal of Science & Engineering, 2011, 38(2A): 131-146.

• Acute phase proteins
• Cytokines
• Hemodialysis
• Pseudomonas aeurginosa
• Water purity

During hemodialysis, blood comes in contact with a large volume of hemodialysis fluid. The dialysis fluid consists mainly of treated water. Since the purity of water has been linked to acute and long-term complications in hemodialysis patients, the aim of this study is to assess serum levels of some pro-inflammatory cytokines (IL-1 beta and TNF-alpha), acute phase proteins (C-reactive protein, ferritin and fibrinogen), and microbial analysis, with chronic inflammatory response in hemodialyzed patients that may be due to insufficient treatment of the water used for hemodialysis. Eighty subjects were included in the present study, 20 normal subjects as control and 60 hemodialysis patients from two different dialysis units (30 for each group) with age ranges from 28-75 years. All subjects were free from any inflammatory symptoms, according to the data received from the questionnaires (i.e. rise in body temperature, fever, chills, headache, loss of appetite and fatigue). IL-1 beta, TNF-alpha, CRP, ferritin and fibrinogen were significantly increased in all patients compared to normal controls. Based on microbiological analysis, water may be judged to be clean, even if in reality it is outside of standard recommendations. Although several causes contribute to the chronic micro-inflammatory state of uremic patients on dialysis, a small contamination of dialysate water with bacterial endotoxin may be an important factor to be considered.

• 出版日期2011-12