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Endotoxemia in chronic renal failure.

U Nisbeth, R Hällgren, O Eriksson

    Nephron
    |January 1, 1987
    PubMed
    Summary

    Patients with chronic renal failure often have elevated endotoxin levels, especially those undergoing hemodialysis. This suggests potential issues with endotoxin clearance or entry during renal replacement therapies.

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    Area of Science:

    • Nephrology
    • Toxicology
    • Immunology

    Background:

    • Pyrogenic reactions from dialyzers are rare due to improvements.
    • Some dialysis patients exhibit symptoms possibly linked to endotoxins.
    • Elevated circulating endotoxin levels were observed in symptomatic patients and controls.

    Purpose of the Study:

    • To measure endotoxin levels in patients with chronic renal failure undergoing various treatments.
    • To compare endotoxin levels between different renal replacement therapies and healthy individuals.
    • To investigate potential mechanisms for endotoxemia in uremia.

    Main Methods:

    • Serum samples from patients and healthy controls were analyzed.
    • A sensitive assay using chromogenic substrate and Limulus amebocyte lysate was employed.
    • Endotoxin levels were quantified in ng/l.

    Main Results:

    • Hemodialysis patients showed significantly elevated endotoxin levels (40 +/- 4.7 ng/l) compared to healthy controls (7 +/- 0.6 ng/l).
    • Increased endotoxin levels were also found in hemofiltration (19 +/- 7.5 ng/l) and conservative treatment (17 +/- 2.5 ng/l) groups.
    • Peritoneal dialysis and renal-transplanted patients had endotoxin levels similar to controls.

    Conclusions:

    • Endotoxemia is prevalent in patients with chronic renal failure, particularly those on hemodialysis.
    • Reduced endotoxin elimination due to impaired liver macrophage function may contribute to endotoxemia in uremia.
    • Dialysis regimens, especially extracorporeal circulation, might influence endotoxin levels.

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