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NDT Advance Access originally published online on October 25, 2005
Nephrology Dialysis Transplantation 2006 21(2):546; doi:10.1093/ndt/gfi223
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© The Author [2005]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

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Email: linyf{at}ndmctsgh.edu.tw

Sir,

We would like to thank the authors for their interest and comments on our study [1]. Myeloperoxidase (MPO), abundantly stored in primary granulocytes of polymorphonuclear leukocytes and released from degranulated neutrophils, has been considered an important pathophysiological factor in oxidative stress during the haemodialysis (HD) process and may serve as a reliable indicator of oxidative stress during single HD sessions. The kinetic changes of MPO at different access sites during a single HD session using a biocompatible membranes and ultrapure dialysate reveal the differences in MPO production between arterial and venous sites. However, if interpreting this phenomenon as resulting from the interaction with dialyser as the author proposed, other important factors, such as ultrafiltration during HD, that may affect the arterio-venous difference in MPO levels should also be considered [2]. The MPO levels were checked at 0, 15, 120 and 240 min after starting HD in our study but we did not find that peak MPO levels were apparent at 30 min as stated by Kreiter et al. A prominent difference in MPO production between two different biocompatible dialysis membranes in our study may imply that the bioincompatibility of the membranes also seems to play an important role in the increased production of oxidative stress. As Kreiter et al. point out, early high arterial MPO levels may indicate that other factors such as the dialysis per se may contribute to the MPO production. The ultrapure dialysate used in their study may partly explain why the MPO levels were lower than those in our study and it also suggests the role the dialysate played in the generation of oxidative stress during HD. Taken together, not only the interaction with dialyser but also other factors such as the dialysis per se and dialysate contaminants should be considered as contributing to oxidative stress in HD patients.

Conflict of interest statement. None declared.

Chia-Chao Wu, Shih-Hua Lin and Yuh-Feng Lin

Division of Nephrology Department of Internal Medicine Tri-Service General Hospital Taipei Taiwan

References

  1. Wu CC, Chen JS, Wu WM et al. Myeloperoxidase serves as a marker of oxidative stress during single haemodialysis session using two different biocompatible dialysis membranes. Nephrol Dial Transplant 2005; 20: 1134–1139[Abstract/Free Full Text]
  2. Locatelli F, Buoncristiani U, Canaud B et al. Haemodialysis with on-line monitoring equipment: tools or toys?Nephrol Dial Transplant 2005; 20: 22–33.[Abstract/Free Full Text]

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This Article
Right arrow Extract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
21/2/546-a    most recent
gfi223v1
Right arrow Alert me when this article is cited
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Right arrow Articles by Wu, C.-C.
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