Abstract
In order to confirm whether or not very low endtoxin level in dialysate influences the formation of advanced glycation end products (AGEs) in dialysis patients, plasma pentosidine were determined in the dialysis patients before and after the switch to new water-supply system. Method: Plasma pentosidine were measured by high-performance liquid chromatography in 84 patients on long-term hemodialysis before 3 month, 6 months after the switch of dialysate endtoxin level from 0.020–0.025 to 0.001 EU/ml. Endtoxin measurement was done by the Wellreader SK603 (Seikagaku Kogyo Co. Tokyo) by which detection limit is less than 0.001 EU/ml. The plasma pentosidine levels fell from 1.55 ± 0.61 nmol/ml to 1.38 ± 0.52 nmol/ml (3 month after, p < 0.0001) and 1.31 ± 0.50 nmol/ml (6 month after, p < 0.0001). The fall in plasma pentosidine levels were equally observed in patients given dialysis with high-flux polysulfone, PMMA, and cellulose acetate membranes. Unexpectedly, the plasma triglycerides levels fell from 150 ± 116 mg/dl to 124 ± 79 mg/dl (3 month after, p < 0.01) and 119 ± 75 mg/dl (6 month after, P < 0.01). The levels of total cholesterol, c-reactive protein, β 2-microglobulin did not change during this study. Conclusion: Water purity of dialysis fluid has an impact on AGE formation and improve a status of lipid metabolism in hemodialysis patients even if endtoxin level was very low.
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