| 特集名 | 生体適合面からみた透析機器 | |
|---|---|---|
| 題名 | 透析液の清浄度とサイトカインの関連 | |
| 発刊年月 | 2004年 05月 | |
| 著者 | 武本 佳昭 | 大阪市立大学大学院医学研究科泌尿器病態学 |
| 著者 | 土田 健司 | 大阪市立大学大学院医学研究科泌尿器病態学 |
| 著者 | 吉村 力勇 | 大阪市立大学大学院医学研究科泌尿器病態学 |
| 著者 | 仲谷 達也 | 大阪市立大学大学院医学研究科泌尿器病態学 |
| 【 要旨 】 | 血液透析療法に使用する透析液の水質は，治療の質を決定する非常に大きな要因と考えられる．従来は透析液中の汚染物質が透析膜を介して生体内へ流入すると考えられていなかったが，最近では汚染物質が生体内へ流入し，炎症性サイトカインを惹起すると考えられるようになってきた．したがって近年，透析液の水質がますます重要になってきている． 透析関連アミロイドーシスの発症が透析液清浄化によって抑制されることや腎性貧血に対して炎症性サイトカインが悪影響を与えることが明らかになってきた． 本稿では，透析液の清浄化が血液透析患者の血中炎症性サイトカイン濃度に与える影響および透析関連アミロイドーシス，腎性貧血に与える影響を文献的に解説することを試みた． |
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| Theme | Biocompatibility on Materials for Dialysis Equipments and Devices | |
|---|---|---|
| Title | Relationships between inflammatory cytokines and dialysate purity | |
| Author | Yoshiaki Takemoto | Department of Urology, Osaka City University Graduate School of Medicine |
| Author | Kenji Tsuchida | Department of Urology, Osaka City University Graduate School of Medicine |
| Author | Rikio Yoshimura | Department of Urology, Osaka City University Graduate School of Medicine |
| Author | Tatsuya Nakatani | Department of Urology, Osaka City University Graduate School of Medicine |
| [ Summary ] | Microbiological dialysate contamination was remained relatively ignored in relation to hemodialysis until the 90 ies because there was a strong convinion that these contaminantes could not pass through the dialyser membrane during hemodialysis therapy. Recently, dialysate purity has become the major concern in hemodialysis therapy. The reasons are as follows: first, the use of highly permeable dialyser membranes has enhanced the backfiltration from the dialysate to the blood, which enhances the risks of contaminantion of dialysis fluids. Secondly, it has been shown that bacteria-derived products (endotoxins, peptidoglycans, etc) result in the synthesis and release of proinflammatory cytokines (IL-1, TNF, IL-6, etc) via the activation of monocytes/macrophages during hemodialysis therapy. Thirdly, it has also been reported that dialysis related amyloidosis, such as carpal tunnel syndrome was delayed by the use of ultrapure dialysates. Therefore, ultrapure dialysates should be used all hemodialysis patients in the near future. | |