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Abstract
HBV Vaccination in the Patient with Chronic Renal Disease
Ennio Duranti and Diletta Duranti
Patients undergoing hemodialysis often present with a reduced response to anti-hepatitis B virus (anti-HBV) vaccination. The soluble form of CD40 (sCD40) is elevated in hemodialysis patients and this has been shown to correlate with lack of response to anti-HBV vaccination. Due to its high molecular weight, conventional dialyzers cannot clear sCD40. Dialysis membranes in polymethylmethacrylate (PMMA) can reduce the levels of sCD40. We have used PMMA membranes in patients who were non-responders to anti-HBV vaccination (anti-HB antibody level<10 UI/L after 2 vaccinations circles). Interestingly, we found that significantly more patients in the PMMA group were able to mount a response to vaccination, compared to the control group.