الفهرس 
Hemodialysis
Bacterial EndotoxinOnly 14 pages are availabe for public view
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Abstract
Patientswithchronic kidney disease and especially thoseonhemodialysishavemultiplepotentialsourcesfor endotoxemia.(JonathanWet al,.2015)
Long-termendotoxinchallengemaypromotefrequent complicationsin dialysis patients, namely malnutrition, chronicinflammation,and atherosclerosis, which are recognizedas the so-called MIA syndrome. (Ahmed F, et al.2013)
HCVinfectionhasanegativeimpactonthesurvivalof hemodialysis patients, attributed mostly to HCV-related liverdiseaseand its complications.(Moini Met al,.2013)
Serumendotoxinlevelsweresignificantly higher in patientwithhepaticencephalopathyandminimalhepatic encephalopathyascomparedtopatientswithout minimal hepaticencephalopathyandhealthycontrols. (Lokesh J et al,.2012)
Preventionofendotoxemia,throughtreatingfociof endotoxin (periodontal disease, catheters, vascular access) orreducingtranslocationfrom the gut will potentially reduce the inflammatory response. These anti- inflammatorystrategiesmaybeefficientinreducing complicationsrelatedtoinflammationinCKDpatients (Hauser A.B.et al.,2011).
Theaimofthisstudyistostudypossiblerelationship betweenendotoxemiaandHCVinfectioninchronic hemodialysis patients.
Thiscrosssectionalstudywastakingplace in hemodialysis centers of Ain Shams university hospital. Thestudywasdoneon40 hemodialysis patients divided into 4 groups:
Group 1: 10 HCV positive patients Child A on regular hemodialysis
Group 2: 10 HCV positive patients Child B on regular
hemodialysis
Group 3: 10 HCV positive patients Child C on regular hemodialysis
Group 4: 10 HCV negative patients on regular hemodialysis
This study including 60% males (n=24) and 40% females (n=16), the mean age was 51.05 years and the meanduration ofhemodialysis was 65.59 months.
Inourstudy,themeanpre-dialysis endotoxin level was0.37± 0.09 Eu/ml. and the mean post-dialysis endotoxinlevelwas0.39±0.12Eu/ml.35%ofthepatients (n=14)showednochangeintheserumendotoxinlevel throughout the HD session. Meanwhile, 30% of the patients (n=12) showed an increase in serum endotoxin leveland35%ofthepatients(n=14)showedadecrease in serumendotoxin level throughout thesession.
Ourstudyshowedasignificantnegativecorrelation betweenpre-dialysis endotoxin level and serum albumin level (p=0.03).
Ourstudyshowedasignificantpositivecorrelation betweenpre-dialysisendotoxin level and HsCRP level (p=0.03).
Inourstudy,thereissignificant statistical difference betweenstudy groupsandpre-dialysisendotoxinlevel (p=0.04).HCVnegativepatients(group4)havepre-dialysis endotoxinlevelmean0.32lowerthanothergroups. And HCVpositivepatientschildC(group3)havepre-dialysis endotoxinlevelmean0.42higherthanothergroups.While meanpre-dialysisendotoxinlevelinHCVpositivepatients childA(group1) andB(group2) is0.40 and 0.36 respectively.