Endotoxemia in end-stage kidney disease

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22 Citations (Scopus)


Chronic unexplained inflammation remains a prevalent and clinically significant problem for patients with end-stage kidney disease (ESKD), especially in the dialysis population. The causes of persistent inflammation are likely to be multifactorial, but the underlying mechanisms remain to be elucidated. Endotoxins are reported to play a significant role in the pathogenesis of inflammation in patients with ESKD. However, blood endotoxin measurement with the Limulus amoebocyte lysate (LAL) assay is difficult with current detection systems. The reported degree and prevalence of endotoxemia varies in the literature. There are questions as to whether endotoxemia is truly present; whether the varied findings are due to methodological issues with the LAL assay and whether any endotoxemia that might be present plays a role in chronic inflammation frequently observed in ESKD patients. This review will discuss the challenges of accurate blood endotoxin detection, the potential source of blood endotoxins, and the significance of endotoxemia to patient with ESKD.

Original languageEnglish
Pages (from-to)59-67
Number of pages9
JournalSeminars in Dialysis
Issue number1
Early online date13 Jul 2014
Publication statusPublished - 8 Jan 2015


  • Endotoxemia
  • Humans
  • Kidney Failure, Chronic
  • Limulus Test
  • Membrane Proteins
  • Reproducibility of Results


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