| [ Summary ] |
Dialysis-related amyloidosis is one of the most important complications for long-term dialysis patients. To reduce the concentration of amyloidogenic proteins (i.e. beta 2-microglobulin) below the aggregation threshold, it is possible to promote the clearance of amyloidogenic proteins using various blood purification techniques such as high-flux hemodialysis, off-line hemodiafiltration, on-line hemodiafiltration, or hemodialysis with direct hemoperfusion (Lixelle). On-line hemodiafiltration improves survival rates for dialysis patients. Ultrapure dialysis fluids may delay the onset of dialysis-related amyloidosis including conditions such as carpal tunnel syndrome. The present standards for dialysate purity in Japan (the year 2008) are CFU levels of < 0.1 CFU/ml and endotoxin levels of < 0.001 EU/ml. |