Properties and participation of “free” endotoxin in the toxic activity ofMorganella morganii

Bartková, G; Majtán, V.

doi:10.1007/bf02925628

Cited by 1 publication

(1 citation statement)

References 17 publications

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“…Second, we measured a composite of free (more active) and bound (less active) endotoxin. 79 , 80 We previously used the same methodology to correlate total levels with important clinical effects 3 showing the value of composite endotoxin measurement. Third, this was a pilot experiment with a modest sample size of 15 patients, and generalization of findings should be withheld until a larger, randomized controlled trial is performed.…”

Section: Discussionmentioning

confidence: 99%

Exploring the Link Between Hepatic Perfusion and Endotoxemia in Hemodialysis

Marants

Qirjazi

Lai

et al. 2021

Kidney International Reports

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Introduction:The liver receives gut-derived endotoxin via the portal vein, clearing it before it enters systemic circulation. Hemodialysis negatively impacts the perfusion and function of multiple organs systems. Dialysate cooling reduces hemodialysis-induced circulatory stress and protects organs from ischemic injury. This study examined how hemodialysis disrupts liver hemodynamics and function, its effect on endotoxemia, and the potential protective effect of dialysate cooling.Methods: Fifteen patients were randomized to receive either standard (36.5 C dialysate temperature) or cooled (35.0 C) hemodialysis first in a two-visit crossover trial. We applied computed tomography (CT) liver perfusion imaging to patients before, 3 hours into and after each hemodialysis session. We measured hepatic perfusion and perfusion heterogeneity. Hepatic function was measured by indocyanine green (ICG) clearance. Endotoxin levels in blood throughout dialysis were also measured.Results: During hemodialysis, overall liver perfusion did not significantly change, but portal vein perfusion trended towards increasing (P ¼ 0.14) and perfusion heterogeneity significantly increased (P ¼ 0.038). In addition, ICG clearance decreased significantly during hemodialysis (P ¼ 0.016), and endotoxin levels trended towards increasing during hemodialysis (P ¼ 0.15) and increased significantly after hemodialysis (P ¼ 0.037). Applying dialysate cooling trended towards abrogating these changes but did not reach statistical significance compared to standard hemodialysis. Conclusion:Hemodialysis redistributes liver perfusion, attenuates hepatic function, and results in endotoxemia. Higher endotoxin levels in end-stage renal disease (ESRD) patients may result from the combination of decreased hepatic clearance function and increasing fraction of liver perfusion coming from toxin-laden portal vein during hemodialysis. The protective potential of dialysate cooling should be explored further in future research studies.

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Section: Discussionmentioning

confidence: 99%