الفهرس 
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Abstract
In HD patients, inflammatory mediators, such as IL-1, IL-6, and tumor necrosis factor alpha, cause synthesis and release of C-reactive protein (CRP), decreased albumin, prealbumin, and increased homocysteine and endothelin I. However, IL-6 and hsCRP, besides being inflammatory markers, have emerged as independent predictors of mortality in ESRD patient.
Currently available dialysis fluid delivery systems include the single-patient dialysis fluid delivery system (SPDDS) and central dialysis fluid delivery systems (CDDS).
This study was conducted on 100 end-stage renal disease on hemodialysis patients, they were divided into two study groups each included 50 patients. group (1) included patients receiving regular dialysis by central dialysis fluid delivery system (CDDS) for at least one year before starting the study, while group (2) receiving regular dialysis by single patient dialysis fluid delivery system (SPDDS). Patients underwent full clinical assessment including thorough history taking, clinical examination, routine investigation, IL-6 and hsCRP testing to all patients.
Central dialysis fluid delivery system (CDDS) seems to have a better effect on systemic inflammation (IL-6 and hsCRP) as compared with single-patient dialysis fluid delivery system (SPDDS).
There is a statistically negative correlation between serum IL-6 and hsCRP levels with dry weight, Hemoglobin level, serum creatinine level & serum albumin level for group (1) (CDDS). However, there is a statistically positive correlation between serum IL-6 and hsCRP levels with Total Leuckocytic Count (TLC), serum ferritin level, serum potassium level, weight gain and duration of dialysis for group (2) (SPDS).
These changes might confer long term clinical benefits, calling for the design of a large randomized controlled trial of CDDS versus SPDS aimed at examining other inflammatory markers, nutritional and cardiovascular morbidity and mortality in dialysis patients.
This study has some limitations, mainly the relatively small number of patients and inadequate water purification.
However, for obtaining more definite conclusion in this field and evaluation CDDS predicting role in this field, it is recommended to study other novel inflammatory markers as well as the additive effect of the inflammatory factors with traditional ones in larger sample size and longer follow-up including also oxidative stress, nutritional and anemia parameters.