A vitamin E-coated polysulfone membrane reduces serum levels of inflammatory markers and resistance to erythropoietin-stimulating agents in hemodialysis patients: results of a randomized cross-over multicenter trial
| Autor: | Filomena Pansa, Giovanni Grazi, Beatrice Braccagni, Marina Biagioli, Alberto Rosati, E. Sansoni, Giacli' Donati, Roberto Daini, Giovanni Manca Rizza, Sabrina Paoletti, Carlo Donadio, Luigi Moriconi, Giada Bernabini, Cristina Grimaldi, Giuliano Barsotti, Sara Beati, G. Garosi, Antonio Mannarino, Daniela Angelini, Arturo Rossi, Stefano Bianchi, Roberto Bigazzi, Carlo Mura, Donella Boracelli, Aldo Casani, V. Finato, M. Parrini, Paolo Francesco Ferrandello, Patrizio Imperiali, Vincenzo Panichi, Isabella Petrone, Antonino Sidoti, Massimiliano Migliori |
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| Rok vydání: | 2010 |
| Předmět: |
Male
Polymers medicine.medical_treatment medicine.disease_cause Gastroenterology Antioxidants Hemoglobins Coated Materials Biocompatible hemic and lymphatic diseases Vitamin E Single-Blind Method Sulfones Aged 80 and over Cross-Over Studies biology Hematology General Medicine Middle Aged C-Reactive Protein Italy Nephrology Female Hemodialysis medicine.drug medicine.medical_specialty Anemia medicine.drug_class Enzyme-Linked Immunosorbent Assay Renal Dialysis Multicenter trial Internal medicine medicine Humans Erythropoietin Aged business.industry Interleukin-6 C-reactive protein medicine.disease Erythropoiesis-stimulating agent Oxidative Stress Endocrinology biology.protein Hematinics Kidney Failure Chronic Lipid Peroxidation business Oxidative stress Biomarkers Follow-Up Studies |
| Zdroj: | Blood purification. 32(1) |
| ISSN: | 1421-9735 |
| Popis: | Background: Oxidative stress is prevalent in dialysis patients and has been implicated in the pathogenesis of cardiovascular disease and anemia. Vitamin E is a fat-soluble antioxidant that plays a central role in reducing lipid peroxidation and inhibiting the generation of reactive oxygen species. The aim of this cross-over randomized study was to compare the effects of a vitamin E-coated polysulfone (Vit E PS) membrane and a non-vitamin E-coated polysulfone (PS) membrane on inflammatory markers and resistance to erythropoietin-stimulating agents (ESAs). Methods: After a 1-month run-in period of standard bicarbonate dialysis with a synthetic membrane, 62 patients of both genders, and older than 18 years, dialysis vintage 48 ± 27 months, BMI 22 ± 3 (from 13 different dialysis units) were randomized (A-B or B-A) in a cross-over design to Vit E PS (treatment A) and to PS (treatment B) both for 6 months. C-reactive protein (CRP) and interleukin-6 (IL-6) concentrations were determined by a sandwich enzyme immunoassay at baseline and every 2 months; red blood cell count, ESA dose and ESA resistance index (ERI) were assessed monthly. Results: Hemoglobin (Hb) levels significantly increased in the Vit E PS group from 11.1 ± 0.6 g/dl at baseline to 11.5 ± 0.7 at 6 months (p < 0.001) and remained unchanged in the PS group. Although ESA dosage remained stable during the observation periods in both groups, ERI was significantly reduced in the Vit E PS group from 10.3 ± 2.2 IU-dl/kg/g Hb week at baseline to 9.2 ± 1.7 at 6 months (p < 0.001). No significant variation of ERI was observed in the PS group. A significant reduction in plasma CRP and IL-6 levels was observed in the Vit E PS group: CRP from 6.7 ± 4.8 to 4.8 ± 2.2 mg/l (p < 0.001) and IL-6 from 12.1 ± 1.4 to 7.5 ± 0.4 pg/ml (p < 0.05). In the PS group, CRP varied from 6.2 ± 4.0 to 6.4 ± 3.7, and IL-6 from 10.6 ± 2.1 to 9.6 ± 3.5 (p = n.s.). Conclusions: Treatment with Vit E PS membranes seems to lead to a reduction in ESA dosage in HD patients; in addition, a low chronic inflammatory response may contribute to a sparing effect on exogenous ESA requirements. |
| Databáze: | OpenAIRE |
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