Replacement of Renal Function by Dialysis

  • Gerhard Lonnemann
  • Karl M. Koch


In this review we will discuss the importance of bacterial contamination of dialysate fluid and the associated risk of pyrogenic reactions for patients on hemodialysis therapy. The degree of bacterial contamination of dialysate, relevant bacterial species and pyrogenic substances released from these microorganisms will be described. In addition, information about bacteriological methods to determine bacterial growth as well as assays to measure the pyrogenic activity of bacteria-derived substances will be given. Furthermore, we will describe in vitro studies testing the permeability of dialyzer membranes to pyrogenic substances derived from dialysate-born bacteria. We will discuss recent investigations suggesting that bacterial contamination of dialysate may cause repeated stimulation of immuno-competent cells including monocytes, lymphocytes and neutrophils, resulting in increased production of inflammatory mediators in end-stage renal disease (ESRD) patients. Finally, we will describe an effective approach to reduce the bacterial contamination of dialysis and the associated risk of pyrogenic reactions during hemodialysis


ESRD Patient Dialyzer Membrane Blood Compartment Limulus Amebocyte Lysate Limulus Amebocyte Lysate Assay 
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Copyright information

© Kluwer Academic Publishers 1996

Authors and Affiliations

  • Gerhard Lonnemann
    • 1
  • Karl M. Koch
    • 1
  1. 1.Department of NephrologyMedizinische Hochschule HannoverHannover 61Germany

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