OBJECTIVETo evaluate the effects of ultrapure water on the levels of oxidative stress and inflammation parameters in maintenance hemodialysis patients.

METHODSThirty-six stable maintenance hemodialysis patients were involved in this study, who were free of acute infection, vasculitis or disease activity and on hemodialysis therapy for at least 3 months before using ultrapure water. The parameters including serum advanced oxidation protein products (AOPP), malondialdehyde (MDA), glutathione peroxidase (GSH-Px), myeloperoxidase (MPO), albumin (Alb), C-reactive protein (CRP), neopterin , tumor necrosis factor (TNF)-alpha, and interleukin (IL)-6 were measured before and 6, 12 months after use of ultrapure water, respectively.

RESULTSAfter modification of the water management system, the microbial counts and endotoxin concentration decreased significantly (P<0.01). During the study period, the levels of the measured parameters gradually improved, showing significant difference between the time points of measurement (P<0.05). Use of ultrapure water for 6 months significantly improved serum AOPP, MDA, GSH-Px, MPO, Alb, CRP, neopterin, and TNF-alpha levels (P<0.05), and the level of IL-6 was further reduced after 12 months (P<0.05). Serum MPO activity was closely correlated with AOPP (r=0.335, P<0.05) and CRP (r=0.369 or 0.347, P<0.05) before or after use of ultrapure water.

CONCLUSIONSUltrapure water can improve the status of oxidative stress and inflammation in maintenance hemodialysis patients. Serum MPO activity may help estimate the levels of oxidative stress and inflammation.