Document Detail

Intercurrent clinical events are predictive of plasma C-reactive protein levels in hemodialysis patients.
MedLine Citation:
PMID:  12110028     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: In chronic hemodialysis (HD) patients, the repetitive induction of the acute phase response (APR) may induce a chronic micro-inflammatory state, leading to various long-term complications. METHODS: The present prospective study was designed to assess the alterations in the APR in 74 patients who were randomized to HD with a high-flux polysulfone (PS; F 60S), a super-flux PS (F 500S), or a super-flux cellulosic tri-acetate (CTA and CTA with filtered dialysate, CTA(f)) dialyzer. Blood samples collected at the start of the study and after twelve weeks were analyzed for interleukin-6 (IL-6) and C-reactive protein (CRP). In addition to the microbiological quality of the dialysate, the appearance of a "clinical event" was assessed. RESULTS: At baseline, mean IL-6 levels were within the reference range whereas mean CRP levels were slightly elevated. Mean values did not change after 12 weeks of HD with either modality. After subdividing the patients in quartiles with increasing change in plasma CRP, 23.0% of the patients showed a change of more than 8.0 mg/L. In a multiple regression analysis, CRP levels appeared to be independent of the degree of dialysate contamination, the material and the flux characteristics of the devices. In fact, the variable "clinical events" was the only significant predictor of the plasma CRP levels (P < 0.001). CONCLUSIONS: Based on these results, both PS and CTA super-flux dialyzers appear safe for clinical use. Whether changes in CRP values, which are associated with intercurrent clinical events, influence the long-term prognosis of chronic HD patients remains to be established.
Anne van Tellingen; Muriel P C Grooteman; Margreet Schoorl; Piet C M Bartels; Marianne Schoorl; Tjeerd van der Ploeg; Piet M ter Wee; Menso J Nubé
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Kidney international     Volume:  62     ISSN:  0085-2538     ISO Abbreviation:  Kidney Int.     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-07-11     Completed Date:  2003-01-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  632-8     Citation Subset:  IM    
Department of Nephrology, Medical Centre Alkmaar, The Netherlands.
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MeSH Terms
Aged, 80 and over
C-Reactive Protein / metabolism*
Catheters, Indwelling
Colony Count, Microbial
Dialysis Solutions
Follow-Up Studies
Gram-Negative Bacterial Infections / diagnosis
Gram-Positive Bacterial Infections / diagnosis
Interleukin-6 / blood
Kidney Failure, Chronic / blood*,  microbiology,  therapy
Middle Aged
Predictive Value of Tests
Prospective Studies
Renal Dialysis / instrumentation*
Reg. No./Substance:
0/Dialysis Solutions; 0/Interleukin-6; 9007-41-4/C-Reactive Protein

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