Abstract
Background
Dialysis is a chronic inflammatory state due to both decreased renal clearance and increased production of procytokines, moreover extracorporeal factors, such as impurities in dialysis water,etc. The central dialysis fluid delivery system (CDDS) is a cost-effective, laborsaving, time-tested system with good microbial safety, which has been used for 45 years in many countries & this study, studies the effect of (CDDS) on IL6 & hs-CRP levels in prevalent hemodialysis patients.
Aim of the Work
To compare the effect of central dialysis fluid delivery system (CDDS) versus single-patient dialysis fluid delivery system (SPDDS) in purification of water that used in dialysate and its effect on inflammatory markers (hs-CRP & IL-6) levels in prevalent hemodialysis patients.
Patients and Methods
A Case control study that was conducted on 100 patients of end-stage renal disease on hemodialysis in a university-affiliated hospital. Patients were classified into two groups, each included 50 patients; group (1) receiving regular dialysis by central dialysis fluid delivery system (CDDS), while group (2) receiving regular dialysis by single patient dialysis fluid delivery system (SPDDS) . Patients underwent full clinical assessment including thorough history taking, clinical examination, routine investigation, IL-6 and hsCRP testing to all patients.
Results
One hundred prevalent hemodialysis patients were included in this study. In this study, the levels of IL-6 and hs-CRP were found to be significantly higher in group 2 (SPDS) as compared to group 1 (CDDS).
Conclusion
In conclusion, central dialysis fluid delivery system (CDDS) seems to have a better effect on systemic inflammation (IL-6 and hsCRP) as compared with single-patient dialysis fluid delivery system (SPDDS). There is a statistically negative correlation between serum IL-6 and hsCRP levels with dry weight, Hemoglobin level, serum creatinine level & serum albumin level for group (1) (CDDS). However, there is a statistically positive correlation between serum IL-6 and hsCRP levels with Total Leuckocytic Count (TLC), serum ferritin level, serum potassium level, weight gain and duration of dialysis for group (2) (SPDS).
Purification for dialysis fluid in Central Dialysis fluid Delivery System