FlashMed

Titolo	The role of improved water quality on inflammatory markers in patients undergoing regular dialysis
Autore	M.A. RAHMATI, P. HOMEL, N.A HOENICH, R. LEVIN, G. A. KAYSEN, N.W. LEVIN
Referenza	The International Journal of Artificial Organs - Vol. 27 / no. 8, 2004 / pp. 723-727
Contenuto	ABSTRACT: Hemodialysis utilizes large quantities of water for the preparation of dialysis fluid. uch water meets national standards and international standards but a considerable disparity exists between such standards with respect to microbiological purity. This study collated and retrospectively analyzed the impact of upgrading water systems from that specified in the US standards to those specified in European standards on clinical measures associated with inflammation in four metropolitan dialysis units for two periods. Two periods were compared, hree months prior to and six months post upgrading the water treatment systems. The monthly total erythropoietin dosage and intravenous iron supplementation for each patient were also compared over these periods. Variables with significant pre-post differences were assessed using multivariate models to control for confounding factors. The results indicated significant increases in hemoglobin, ferritin and TSat (all p < 0.0001) and albumin (p = 0.0001) were associated with improvement in water quality. Decreases in CRP and creatinine (both p < 0.0001) were also noted. These findings suggest that the current regulations in the United States set the microbiological limits of water and dialysis fluid inappropriately high, and the limits should be revised downwards, since such an approach is reflected in improvement in markers of inflammation. (Int J Artif Organs 2004; 27: 723-7). KEY WORDS: Hemodialysis, C-reactive protein, Endotoxin, Dialysis fluid, Erythropoietin, Iron
Data	19.11.2004

Lista completa