Abstract: Purpose To evaluate the effects of ultrapure dialysate on several main indicators in patients with maintenance hemodialysis (MHD). Methods Fifty patients (25 in nephritis group and 25 in diabetic nephropathy group) treated with MHD for more than one year were followed-up for six months for the monitoring of microbial indices, nutrition related indices, inflammatory indices, microbial quality of the dialysate, β2-microglobulin (β2-MG), blood biochemical indices, C-reactive protein (CRP), dialysis adequacy, and protein catabolic rate (PCR) after using ultrapure dialysate for six months. Results After using ultrapure dialysate for six months, bacterial and endotoxin levels improved (t=3.465, P=0.000), hemoglobin (Hb) and albumin (Alb) increased (t=-1.275, P=0.001), PCR increased (t=-3.332, P=0.000), and β2-MG decreased (t=3.574, P=0.001), while dialysis adequacy (t=0.155, P=0.879) and CRP (t=0.022, P=0.881) showed no significant changes.
After using ultrapure dialysate, CRP in nephritis group was significantly lower than that in diabetic nephropathy group (t=-1.757, P=0.000), but other indices had no significant differences between the two groups (P＞0.05). Multivariate analysis revealed that diabetes (OR=1.566, 95% CI 1.086～2.257, P=0.016) and dry
body weight (OR=1.007, 95% CI 1.002～1.013, P=0.009) were related to the change of CRP. Conclusions After using the high quality of ultrapure dialysate, the microbial parameters in the dialysate increased, nutritional status improved in MHD patient with nephritis and diabetic nephropathy, and the improvement of inflammation status was more significant in MHD patient with nephritis.

Key words: Hemodialysis, ultrapure dialysate, diabetic nephropathy, main indicators