The Effects of Ultrapure Water on Oxidative Stress and Inflammation Levels in Maintenance Hemodialysis Patients

Many studies have reported that dialysis-related pathology (DRP) in long-term hemodialysis patients is one of the most common causes of increased mortality and morbidity in patients with end-stage renal disease. Oxidative stress and chronic micro-inflammatory state induced by dialysis can accelerate the progression of DRP. The bioincompatibility of the dialysis system, especially the dialysate containing microbial contamination and pyrogen components, is closely related to the response to oxidative stress and chronic micro-inflammation.

Contaminated dialysate promotes the generation of reactive oxygen species and accelerates oxidative stress. Bacterial derivatives in dialysate can stimulate monocytes and macrophages to synthesize and release pro-inflammatory factors, which are key mediators of acute or chronic inflammatory diseases in long-term hemodialysis treatment. In order to improve the purity of dialysate, the use of ultrapure water is a basic prerequisite.

To study the effect of ultrapure water on oxidative stress and inflammation levels in maintenance hemodialysis patients. The method of repeated measurement of self-control was used in 36 eligible patients to determine serum advanced oxidation protein products (AOPP1, malondialdehyde (MDA1), glutathione peroxidase (GSH-Px), myeloperoxidase (MPO), albumin (Alb), C-reactive protein (ERa), neopterin, tumor necrosis factor X (TNFI-x)I, interleukin) 6 months and 12 months before and after using ultrapure water. 6 (IL-6) level. Results: After improving the water treatment system, the bacterial and endotoxin content of the dialysis water decreased significantly (P<0.01). During the one-year follow-up, the differences in various test indicators at different time points were statistically significant (P<0.05); at 6 months, the serum AOPP, MDA, GSH-Px, Alb, CRP, neopterin, and TNF-XI levels were significantly improved (P<0.05) compared with those before the use of ultrapure water. There was a very significant difference (P<0.01); at 12 months, IL-6 (/9<0.05) and MDA (P<0.0l1) levels further decreased. Correlation analysis showed that serum MPO activity and AOPP and CRP levels were positively correlated before and after switching to ultrapure water.

Conclusion After switching to ultrapure water, patients' oxidative stress and inflammation levels were significantly reduced, and MPO may be able to indicate both oxidative stress and inflammation levels.