Ultrapure dialysate influences serum myeloperoxidase levels and lipid metabolism.

Background: Ultrapure dialysate (UD) might contribute to improvements in the morbidity and mortality of hemodialysis (HD) patients. However, it is unclear whether increasing dialysate purity affects chronic inflammation, oxidative stress, and lipid abnormalities. Methods: In a prospective cohort study, 126 patients undergoing maintenance HD using conventional dialysate (CD) with one endotoxin cut filter were assigned to either continuation of the same HD or HD using UD (more purified dialysate). At baseline and 6 months we measured lipids, high-sensitive (hs) CRP, oxidative LDL-cholesterol, and myeloperoxidase. Results: Serum myeloperoxidase and hsCRP levels in the UD group were significantly decreased at 6 months compared with the CD group. Multivariate analysis showed that decreases in non-HDL-cholesterol and ApoB at 6 months were independently correlated with changes in myeloperoxidase. Conclusion: Endotoxin-free UD can improve the chronic inflammatory status, oxidative stress, and lipid abnormalities, suggesting a possible contribution to reduced cardiovascular disease risk and ultimately to lowered mortality in HD patients. Copyright (C) 2009 S. Karger AG, Basel