Standard on the new 4008A, DIASAFE® plus enables the safe production of ultrapure dialysis fluid that can contribute to:
Preservation of residual renal function9+
Residual Renal Function has been shown to influence quality of life and mortality of hemodialysis patients1
- Residual Renal Function (RRF) is the ability of native kidneys to eliminate water and uremic toxins in patients with ESRD
- Even in small amounts, preserving RRF lowers mortality and may improve quality of life8,11,13
- Ultrapure dialysis fluid as a standard in all treatments may contribute to the preservation of RRF9
Preservation of residual renal function9
Residual Renal Function has been shown to influence quality of life and mortality of hemodialysis patients1
- Residual Renal Function (RRF) is the ability of native kidneys to eliminate water and uremic toxins in patients with ESRD
- Even in small amounts, preserving RRF lowers mortality and may improve quality of life8,11,13
- Ultrapure dialysis fluid as a standard in all treatments may contribute to the preservation of RRF9
Reduction of inflammation4+
Inflammation is an important risk factor for dialysis patients:2,4,12
- Elevated serum levels of inflammatory markers such as C-reactive protein pose a strong cardiovascular risk and contribute to EPO hyporesponsiveness
- Establishing ultrapure dialysis fluid as a standard could contribute to the reduction of inflammation in dialysis patients12
- In doing so it can contribute to lowering cardiovascular risk & morbidity, and improving response to EPO4,12
Reduction of inflammation4
Inflammation is an important risk factor for dialysis patients:2,4,12
- Elevated serum levels of inflammatory markers such as C-reactive protein pose a strong cardiovascular risk and contribute to EPO hyporesponsiveness
- Establishing ultrapure dialysis fluid as a standard could contribute to the reduction of inflammation in dialysis patients12
- In doing so it can contribute to lowering cardiovascular risk & morbidity, and improving response to EPO4,12
Reduced risk of dialysis related amyloidosis1,2,9+
In long-term HD patients, dialysis-related amyloidosis can be a serious complication
- Dialysis-related amyloidosis results from the build up of ß2-microglobulin (ß2-m) and can lead to carpal tunnel syndrome, chronic pain and decreased joint mobility
- Reduced plasma levels for ß2-m may delay the onset of dialysis-related amyloidosis3,6,7
- The use of ultrapure dialysis fluid has been shown to contribute to the reduction of plasma levels of ß2-m2
- Therefore, setting ultrapure dialysis fluid as standard for all treatments could contribute to delaying the onset and reducing the risk of dialysis related amyloidosis
Reduced risk of dialysis related amyloidosis1,2,9
In long-term HD patients, dialysis-related amyloidosis can be a serious complication
- Dialysis-related amyloidosis results from the build up of ß2-microglobulin (ß2-m) and can lead to carpal tunnel syndrome, chronic pain and decreased joint mobility
- Reduced plasma levels for ß2-m may delay the onset of dialysis-related amyloidosis3,6,7
- The use of ultrapure dialysis fluid has been shown to contribute to the reduction of plasma levels of ß2-m2
- Therefore, setting ultrapure dialysis fluid as standard for all treatments could contribute to delaying the onset and reducing the risk of dialysis related amyloidosis
References
- Baz M, Durand C, Ragon A, Jaber K, Andrieu D, Merzouk T, Purgus R, Olmer M, Reynier JP, Berland Y: Using ultrapure water in hemodialysis delays carpal tunnel syndrome. Int J Artif Organs 1991; 14: 681–685.
- Furuya R et al. Ultrapure Dialysate Reduces Plasma Levels of ß2-Microglobulin and Pentosidine in Hemodialysis Patients. Blood Purif 2005;23: 311–316.
- Gejyo F, Yamada T, Odani S. A new form of amyloid protein associated with chronic hemodialysis was identified as B2 -microglobulin. Biochem Biophys Res Commun 1985; 129:701–706.
- Lederer SR, Schiffl H. Ultrapure Dialysis Fluid Lowers the Cardiovascular Morbidity in Patients on Maintenance Hemodialysis by Reducing Continuous Microinflammation. Nephron 2002; 91: 452–455.
- Liyanage T et al. Worldwide access to treatment for end-stage kidney disease: a systematic review.
www.thelancet.com Published online March 13, 2015 http://dx.doi.org/10.1016/S0140-6736(14)61601-9 - Miyata T, Inagi R, Iida Y. Involvement of B2 – macroglobulin modified with advanced glycation end products in the pathogenesis of hemodialysis-associated amyloidosis. J Clin Invest 1994; 93: 521–528.
- Miyata T, Oda O, Inagi R. B2 -Microglobulin modified with advanced glycation end products is a major component of hemodialysis-associated amyloidosis. J Clin Invest 1993; 92: 1243–1252.
- Obi Y., Rhee C., Mathew A. Residual Kidney Function Decline and Mortality in Incident Hemodialysis Patients. J Am Soc Nephrol 2016; 27: 3758–3768
- Schiffl H. Nephrol Dial Transplant. 2000; 15(6):840-5. Clinical manifestations of AB-amyloidosis: Effects of biocompatibility and flux
- Schiffl H et al. Ultrapure dialysis fluid slows loss of residual renal function in new dialysis patients. Nephrol Dial Transplant 2002; 17: 1814–1818.
- Shafi T., Jaar B., Plantinga L. Association of Residual Urine Output With Mortality, Quality of Life, and Inflammation in Incident Hemodialysis Patients: The Choices for Healthy Outcomes in Caring for End-Stage Renal Disease (CHOICE) Study. Am J Kidney Dis 2010; 56:348-358
- Sitter Tet al. Dialysate related cytokine induction and response to recombinant human erythropoietin in haemodialysis patients. Nephrol Dial Transplant 2000; 15: 2107–1211.
- Termorshuizen F., Dekker F.Van Manen J. Relative Contribution of Residual Renal Function and Different Measures of Adequacy to Survival in Hemodialysis Patients: An analysis of the Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD)-2. J Am Soc Nephrol 2004; 15: 1061–1070

