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        Endotoxemia in end-stage kidney disease

        Author
        Wong, Jonathan
        Vilar, Enric
        Farrington, Kenneth
        Attention
        2299/18876
        Abstract
        Chronic unexplained inflammation remains a prevalent and clinically significant problem for patients with end-stage kidney disease (ESKD), especially in the dialysis population. The causes of persistent inflammation are likely to be multifactorial, but the underlying mechanisms remain to be elucidated. Endotoxins are reported to play a significant role in the pathogenesis of inflammation in patients with ESKD. However, blood endotoxin measurement with the Limulus amoebocyte lysate (LAL) assay is difficult with current detection systems. The reported degree and prevalence of endotoxemia varies in the literature. There are questions as to whether endotoxemia is truly present; whether the varied findings are due to methodological issues with the LAL assay and whether any endotoxemia that might be present plays a role in chronic inflammation frequently observed in ESKD patients. This review will discuss the challenges of accurate blood endotoxin detection, the potential source of blood endotoxins, and the significance of endotoxemia to patient with ESKD.
        Publication date
        2015-01-08
        Published in
        Seminars in Dialysis
        Published version
        https://doi.org/10.1111/sdi.12280
        Other links
        http://hdl.handle.net/2299/18876
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