The level of endotoxins in hemodialysis water and dialysate in Lithuanian hemodialysis centers.
The composition and quality of the dialysis fluid play an important role in the modulation of dialysis-related complications. During hemodialysis, patient's blood has a contact with dialysate through a semipermeable membrane. Bacterial endotoxins can pass through the membrane pores into the patient's blood and cause a silent chronic microinflammation. The aim of this study was to determine the level of endotoxins in hemodialysis water and dialysate in Lithuanian hemodialysis centers. Dialysis water (n=50) and dialysate (n=50) were collected from 91% (n=50) of all hemodialysis centers. The presence of bacterial endotoxins was evaluated using a sensitive Limulus amebocyte lysate test, which detects intact lipopolysaccharides. The level of endotoxins was lower than 0.25 EU/mL in 43 (86%) dialysis water samples and in 46 (92%) dialysate samples, and complied with the recommendations of the European Pharmacopoeia and the European Best Practice Guidelines for pure dialysis fluid. The dialysate of 39 (78%) Lithuanian hemodialysis centers complied with the definition of an ultrapure dialysis fluid. The water and dialysate were of insufficient quality in 14% and in 8% of Lithuanian hemodialysis centers, respectively, and this could be improved by the establishment of routine investigation of endotoxins.
Department of Nephrology, Kaunas University of Medicine, Eivenių 2, 50028 Kaunas, Lithuania. i.skarupskiene@mikrovisata.net.
Inga
I
Skarupskienė
Inga Arūnė
IA
Bumblytė
Donatas
D
Tamošaitis
Jūratė
J
Venterienė
Vytautas
V
Kuzminskis
D002908:Chronic Disease; D003627:Data Interpretation, Statistical; D004731:Endotoxins / Q000032:analysis* / Q000097:blood*; D005060:Europe; D015312:Hemodialysis Solutions / Q000592:standards; D006801:Humans; D007249:Inflammation / Q000209:etiology; D007688:Kidneys, Artificial; D008033:Limulus Test; D008097:Lithuania; D017410:Practice Guidelines as Topic; D006435:Renal Dialysis / Q000009:adverse effects; D014867:Water
D004731:Endotoxins; D015312:Hemodialysis Solutions; D014867:Water