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NDT Advance Access originally published online on January 12, 2005
Nephrology Dialysis Transplantation 2005 20(2):266-270; doi:10.1093/ndt/gfh571
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Nephrol Dial Transplant Vol. 20 No. 2 © ERA–EDTA 2005; all rights reserved

Editorial Comment

Is biofilm a cause of silent chronic inflammation in haemodialysis patients? A fascinating working hypothesis

Gianni Cappelli1, Ciro Tetta2 and Bernard Canaud3

1 Department of Nephrology, Dialysis and Transplantation, University of Modena, Modena, Italy, 2 Fresenius Medical Care Deutschland GmbH, Bad Homburg, Germany and 3 Nephrology and Renal Research and Training Institute, CHU Montpellier, Montpellier, France

Correspondence and offprint requests to: Professor Bernard Canaud, Nephrology, Lapeyronie University Hospital, CHU Montpellier, 371, Avenue du Doyen G. Giraud, 34925 Montpellier, France. Email: b-canaud@chu-montpellier.fr

Keywords: biofilm; chronic inflammation; C-reactive protein; haemodialysis adequacy

The first 150 words of the full text of this article appear below.



   Introduction
 
Knowledge of biofilm formation and its biological role in chronic subclinical inflammation has largely evolved over the past years [1–5]. The development of a biofilm is a very effective way for bacteria to survive facing hostile conditions and to resist biocides and antimicrobial substances. The initial event in biofilm formation is the adhesion of microbes to surfaces. The surface properties of medical devices are usually modified by a conditioning film of organic material. The effect of single blood proteins or of whole blood itself depends on bacterial strains. Fibrinogen and fibronectin both enhance Staphylococcus aureus binding and inhibit Staphylococcus epidermidis or Gram-negative bacteria adherence, while whole blood promotes Pseudomonas aeruginosa biofilm formation [6].

Biofilm is not a static simple matrix made of homogeneous slime embedding bacteria. This sessile multicellular community is a dynamic complex system made of exopolysaccharide matrix embedding living microorganisms with a phenotype modified . . . [Full Text of this Article]



   Vascular access in haemodialysis patient
 


   Haemodialysis monitors
 


   Conclusions
 

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