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Titolo:
Effects of ultrapure dialysis fluid on nutritional status and inflammatoryparameters
Autore:
Schiffl, H; Lang, SM; Stratakis, D; Fischer, R;
Indirizzi:
Univ Munich, Med Klin Innenstadt, Dept Nephrol, D-80336 Munich, Germany Univ Munich Munich Germany D-80336 Dept Nephrol, D-80336 Munich, Germany Univ Munich, Med Poliklin Innenstadt, Dept Nephrol, D-80336 Munich, Germany Univ Munich Munich Germany D-80336 Dept Nephrol, D-80336 Munich, Germany
Titolo Testata:
NEPHROLOGY DIALYSIS TRANSPLANTATION
fascicolo: 9, volume: 16, anno: 2001,
pagine: 1863 - 1869
SICI:
0931-0509(200109)16:9<1863:EOUDFO>2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
INTERLEUKIN-1 RECEPTOR ANTAGONIST; RECOMBINANT-HUMAN-ERYTHROPOIETIN; HEMODIALYSIS-PATIENTS; ONLINE HEMODIAFILTRATION; CYTOKINE INDUCTION; MORTALITY; MALNUTRITION; FAILURE; SAFETY;
Keywords:
biocompatibility; cytokines; dialysis fluid; haemodialysis; nutrition;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
29
Recensione:
Indirizzi per estratti:
Indirizzo: Schiffl, H Univ Munich, Med Klin Innenstadt, Dept Nephrol, Ziemssenstr 1, D-80336 Munich, Germany Univ Munich Ziemssenstr 1 Munich Germany D-80336 nich, Germany
Citazione:
H. Schiffl et al., "Effects of ultrapure dialysis fluid on nutritional status and inflammatoryparameters", NEPH DIAL T, 16(9), 2001, pp. 1863-1869

Abstract

Background. Malnutrition and chronic systemic inflammatory response syndrome not only coexist in uraemia, but may also have a bi-directional cause-and-effect relationship. To evaluate the role of dialysate-related cytokine induction in inflammatory response and nutritional status, we conducted a prospective comparison of two dialysis fluids differing in their microbiological quality. Methods. Forty-eight early haemodialysis patients were assigned to either treatment with conventional (potentially microbiologically contaminated) oron-line produced ultrapure dialysis fluid. Study parameters were bacterialgrowth, markers of systemic inflammation (C-reactive protein (CRP) and interleukin 6), and parameters of nutritional status (estimated dry weight, upper mid-arm muscle circumference, serum albumin concentration, insulin-likegrowth factor 1, leptin, and protein catabolic rate). Patients were followed for 12 months. Results. There were no statistically significant differences in demographic and treatment characteristics, degree of bacterial contamination of the dialysate, markers of systemic inflammation, or parameters of nutritional status among the two treatment groups at recruitment. Changing from conventional to ultrapure dialysis fluid reduced significantly the levels of IL-6 (19 +/-3 pg/ml to 13 +/-3 pg/ml) and CRP (1.0 +/-0.4 mg/dl to 0.5 +/-0.2 mg/dl), and resulted in significant increases in estimated dry body weight, mid-arm muscle circumference, serum albumin concentration, levels of the humoral factors, and in protein catabolic rate after 12 months. Continuous use of conventional dialysis fluid (median 40-60 c.f.u./ml) was not associated with significant alterations in markers of inflammation (IL-6 21 +/-4 pg/ml vs 24 +/-6 pg/ml, CRP 0.9 +/-0.3 mg/dl vs 1.1 +/-0.4 mg/dl) or of nutritional status at any time of the study. All differences in systemic inflammation and nutritional parameters observed during the study period (from recruitment to month 12) were significant between the two patient groups. Conclusions. Cytokine induction by microbiologically contaminated dialysisfluid has a negative impact on nutritional parameters of early haemodialysis patients. The microbiological quality of the dialysis fluid represents an independent determinant of the nutritional status in addition to known factors, such as dose of dialysis and biocompatibility of the dialyser membrane. Ultrapure dialysis fluid adds to the cost of the dialytic treatment, but may improve the nutritional status in long-term haemodialysis patients.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/03/20 alle ore 14:16:04