Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Jaindl, E.
The Influence of Dialysis Treatment on Serum (1¿3)-ß-D-Glucan Levels
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2016. pp.
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- Autor*innen der Med Uni Graz:
- Krause Robert
- Betreuer*innen:
- Prattes Jürgen
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- Abstract:
- Purpose: The purpose of this study was to evaluate whether hemodialysis (HD), hemodiafiltration (HDF) or peritoneal dialysis (PD), using state of the art techniques and devices, are causing false positive serum (1¿3)-ß-D-glucan (BDG) test results. Methods: The study was conducted partially in vivo and partially in vitro. The prospective clinical study enrolled 32 patients with chronic kidney disease (CKD) and without signs of invasive fungal infections (IFIs). Ten of those patients had no ongoing dialysis and were included to eliminate the possibility of CKD as a confounder for elevated BDG levels. Twelve of the patients had ongoing HD/HDF therapy. In this group BDG was measured in serum and dialysate at various time points during dialysis treatment. Ten of the patients received PD and were tested only once for concentrations of BDG in serum and dialysis solution. In the in vitro study, dialysis fluid was spiked with high concentrations of BDG. During a simulated HD session, samples for BDG determination were drawn at various time points. BDG results less than 60 pg/ml were interpreted as negative, 60 to 79 pg/ml as intermediate, greater than or equal to 80 pg/ml as positive. The lower detection limit was 15.4 pg/ml. Results: All patients with CKD and without dialysis had negative serum BDG results. The majority (71 out of 72) of serum samples obtained from HD/HDF patients were BDG negative, resulting in a specificity of 0.99. Only one out of ten serum samples of PD patients yielded a positive result, whereas BDG determination was negative in the remaining nine samples with a specificity of 0.90. All dialysis fluid samples were BDG negative. In the laboratory bench study, the dialyzer did not release BDG, nor did BDG from the BDG spiked dialysate leak into the simulated patient's blood circulation. Conclusion: Based on these data, it can be concluded that serum BDG determination seems to be a reliable diagnostic tool for IFI assessment in patients with ongoing HD/HDF or PD using state of the art techniques.