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dc.contributor.authorThomé, Fernando Saldanhapt_BR
dc.contributor.authorSenger, M.pt_BR
dc.contributor.authorGarcez, C.pt_BR
dc.contributor.authorGarcez, J.pt_BR
dc.contributor.authorChemello, Claricept_BR
dc.contributor.authorManfro, Roberto Cerattipt_BR
dc.date.accessioned2010-04-27T04:16:48Zpt_BR
dc.date.issued2005pt_BR
dc.identifier.issn0100-879Xpt_BR
dc.identifier.urihttp://hdl.handle.net/10183/21279pt_BR
dc.description.abstractAtherosclerosis 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.en
dc.format.mimetypeapplication/pdfpt_BR
dc.language.isoengpt_BR
dc.relation.ispartofBrazilian journal of medical and biological research. Ribeirão Preto, SP. Vol. 38, no. 5 (May 2005), p. 789-794.pt_BR
dc.rightsOpen Accessen
dc.subjectDiálise renalpt_BR
dc.subjectHemodialysisen
dc.subjectProteina C-reativapt_BR
dc.subjectC-reactive proteinen
dc.subjectDialysate wateren
dc.subjectOsmose inversapt_BR
dc.subjectUremiapt_BR
dc.subjectReverse osmosisen
dc.subjectInflammationen
dc.titleDialysis water treated by reverse osmosis decreases the levels of C-reactive protein in uremic patientspt_BR
dc.typeArtigo de periódicopt_BR
dc.identifier.nrb000525156pt_BR
dc.type.originNacionalpt_BR


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