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Dialysis water treated by reverse osmosis decreases the levels of C-reactive protein in uremic patients

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Dialysis water treated by reverse osmosis decreases the levels of C-reactive protein in uremic patients

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Título Dialysis water treated by reverse osmosis decreases the levels of C-reactive protein in uremic patients
Autor Thomé, Fernando Saldanha
Senger, M.
Garcez, C.
Garcez, J.
Chemello, Clarice
Manfro, Roberto Ceratti
Abstract Atherosclerosis is a major complication of chronic renal failure. Microinflammation is involved in atherogenesis and is associated with uremia and dialysis. The role of dialysate water contamination in inducing inflammation has been debated. Our aim was to study inflammatory markers in patients on chronic dialysis, before and 3 to 6 months after switching the water purification system from deionization to reverse osmosis. Patients had demographic, clinical and nutritional information collected and blood drawn for determination of albumin, ferritin, C-reactive protein (CRP), interleukin- 6, and tumor necrosis factor-α in both situations. Acceptable levels of water purity were less than 200 colony-forming units of bacteria and less than 1 ng/ml of endotoxin. Sixteen patients died. They had higher median CRP (26.6 vs 11.2 mg/dl, P = 0.007) and lower median albumin levels (3.1 vs 3.9 g/l, P < 0.05) compared to the 31 survivors. Eight patients were excluded because of obvious inflammatory conditions. From the 23 remaining patients (mean age ± SD: 51.3 ± 13.9 years), 18 had a decrease in CRP after the water treatment system was changed. Overall, median CRP was lower with reverse osmosis than with deionization (13.2 vs 4.5 mg/l, P = 0.022, N = 23). There was no difference in albumin, cytokines, subjective global evaluation, or clinical and biochemical parameters. In conclusion, uremic patients presented a clinically significant reduction in CRP levels when dialysate water purification system switched from deionization to reverse osmosis. It is possible that better water treatments induce less inflammation and eventually less atherosclerosis in hemodialysis patients.
Contido em Brazilian journal of medical and biological research. Ribeirão Preto, SP. Vol. 38, no. 5 (May 2005), p. 789-794
Assunto Diálise renal
Osmose inversa
Proteina C-reativa
Uremia
[en] C-reactive protein
[en] Dialysate water
[en] Hemodialysis
[en] Inflammation
[en] Reverse osmosis
Origem Nacional
Tipo Artigo de periódico
URI http://hdl.handle.net/10183/21279
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