| Ultrapure dialysate for home hemodialysis? | |
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MedLine Citation:
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PMID: 17603979 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Use of ultrapure dialysate (bacteria < 0.1 CFU/mL and endotoxin < 0.03 EU/mL) is associated with a reduction in inflammation and morbidity in patients treated with conventional thrice-weekly dialysis. The improved outcomes obtained with more frequent dialysis schedules have reawakened interest in home hemodialysis. More frequent dialysis also appears to reduce inflammation, and whether combining more frequent dialysis with use of ultrapure dialysate will have an additive effect on inflammation and its consequences remains unclear. Routinely producing ultrapure dialysate in a home environment with a conventional hemodialysis machine poses technical challenges related to the design of the equipment and the intermittent nature of hemodialysis. Solutions to these problems include use of a system in which the water-treatment equipment is fully integrated with the dialysis machine, use of dry-powder cartridges or sterile prepackaged liquids for bicarbonate concentrate, and use of a bacteria-retentive and endotoxin-retentive filter for final purification of the dialysate immediately before it enters the dialyzer. Alternatively, ultrapure dialysate may be achieved with newer machines designed specifically for home hemodialysis that use a new batch of dialysate for each treatment. The volume of dialysate available with these machines, however, currently limits their use to short-daily dialysis. |
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Authors:
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Rosemary Ouseph; Richard A Ward |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Advances in chronic kidney disease Volume: 14 ISSN: 1548-5609 ISO Abbreviation: - Publication Date: 2007 Jul |
Date Detail:
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Created Date: 2007-07-02 Completed Date: 2007-08-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101209214 Medline TA: Adv Chronic Kidney Dis Country: United States |
Other Details:
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Languages: eng Pagination: 256-62 Citation Subset: IM |
Affiliation:
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Department of Medicine, University of Louisville, Louisville, KY 40202-1718, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Bacterial Infections
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prevention & control Female Hemodialysis Solutions / chemistry*, therapeutic use Hemodialysis, Home / methods*, mortality Humans Kidney Failure, Chronic / diagnosis, mortality, therapy* Male Membranes, Artificial* Quality of Life Risk Factors Sensitivity and Specificity Survival Rate Water / pharmacology Water Microbiology Water Purification |
| Chemical | |
Reg. No./Substance:
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0/Hemodialysis Solutions; 0/Membranes, Artificial; 7732-18-5/Water |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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