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dc.contributor.authorJefferies, Helen
dc.contributor.authorCrowley, Lisa
dc.contributor.authorMcIntyre, Christopher
dc.date.accessioned2016-11-03T12:03:53Z
dc.date.available2016-11-03T12:03:53Z
dc.date.issued2014-11
dc.identifier.citationNephron Clin Pract. 2014;128(1-2):141-6. doi: 10.1159/000366519. Epub 2014 Nov 12.language
dc.identifier.urihttps://orda.derbyhospitals.nhs.uk/handle/123456789/645
dc.description.abstractBACKGROUND/AIMS: Endotoxaemia, a driver of systemic inflammation, appears to be driven by dialysis-induced circulatory stress in haemodialysis (HD) patients. More frequent HD regimens are associated with lower ultrafiltration requirements, improved haemodynamic stability and lower systemic inflammation. This study investigated the hypothesis that more frequently dialysed patients, with reduced exposure to dialysis-induced haemodynamic perturbation, would have lower circulating endotoxin (ET) levels. METHODS: A cross-sectional study of 86 established HD patients compared three groups: conventional HD 3× per week (HD3, n = 56), frequent HD 5-6× per week (SDHD, n = 20), and nocturnal HD (NHD, n = 10). Data collection included ultrafiltration volume and rate, serial blood pressures and blood sampling with quantification of ET, troponin T and high-sensitivity CRP (hsCRP). RESULTS: Pre-dialysis serum ET was highest in the conventional HD group (HD3 0.66 ± 0.29 EU/ml vs. NHD 0.08 ± 0.04 EU/ml). Across the study population, severity of endotoxaemia was associated with higher ultrafiltration rates, degree of intradialytic hypotension, troponin T and hsCRP levels. NHD patients had the lowest ultrafiltration requirements, the greatest haemodynamic stability and lower ET levels. CONCLUSION: More frequent HD regimens are associated with lower levels of circulating ET compared with conventional HD. Reduced ET translocation may be related to the greater haemodynamic stability of these treatments, with superior maintenance of splanchnic perfusion.language
dc.language.isoenlanguage
dc.subjectEndotoxinlanguage
dc.subjectChronic Kidney Diseaselanguage
dc.subjectHaemodialysislanguage
dc.subjectInflammationlanguage
dc.subjectIschaemialanguage
dc.subjectCirculatory Stresslanguage
dc.titleCirculating endotoxaemia and frequent haemodialysis scheduleslanguage
dc.typeArticlelanguage


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