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NDT Advance Access originally published online on February 7, 2006
Nephrology Dialysis Transplantation 2006 21(4):1129-1130; doi:10.1093/ndt/gfl003
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© The Author [2006]. 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 are very grateful to Dr Borawski for his thoughtful comments on our article [1]. First, the point that the increase in plasma myeloperoxidase (MPO) was not accompanied by a fall in the circulating neutrophil counts is not correct. There was a significant fall in the circulating neutrophil counts, not only in polysulfone membrane (12.75%, from 4000±490 to 3490±460), but also more prominently in regenerated cellulose membrane (91.01%, from 3450±390 to 310±80) when comparing the baseline with 15 min after haemodialysis (HD).

Second, the author raises the question that the up-regulation of MPO during HD found in our study might be partially explained by the use of exogenous heparin. While accepting this point of view as a plausible explanation, we believe that this does not contradict the role of procedure-related production of MPO during HD, when using two different biocompatible dialysis membranes but heparin as the same anticoagulant. Indeed, whether MPO production is due to a neutrophil activated by the HD process (dialysis per se and dialyser biocompatibility) or due to the heparin-induced MPO release from an endothelial cell, is undetermined.

Third, we believe in the possibility that not only dialysis-associated factors such as dialysis per se, dialyser interaction and dialysate contaminants, but also non-dialysis associated factors such as the severity of atherosclerosis and the use of heparin anticoagulant are involved in the production of MPO. More studies are required to clarify the clinical and pathogenic role of MPO during HD.

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 hemodialysis session using two different biocompatible dialysis membranes. Nephrol Dial Transplant 2005; 20: 1134–1139[Abstract/Free Full Text]
  2. Malle E, Buch T, Grone HJ. Myeloperoxidase in kidney disease. Kidney Int 2003; 64: 1956–1967[CrossRef][Medline]

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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:
21/4/1129    most recent
gfl003v1
Right arrow Alert me when this article is cited
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Right arrow Email this article to a friend
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Right arrow Articles by Wu, C.-C.
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Right arrow Articles by Wu, C.-C.
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