Abstract

The use of vitamin E-bonded cellulose membrane dialyzers has been reported to cause a decrease in oxidative lipid marker levels (Nakai et al., Ther Apher Dial 14:505–540, 1; Nakai et al., J Jpn Soc Dial Ther 45:1–47, 2; Mashiba et al., Arterioscler Thromb Vasc Biol 21:1801–1808, 3). However, few studies have identified this effect with vitamin E-bonded polysulfone membranes, and no studies report the same effect on alpha (1) antitrypsin–LDL complex, a new oxidative lipid marker. This prompted us to examine the influence of use of VPS-HA vitamin E-bonded polysulfone high-flux membrane dialyzers on this new oxidative lipid marker. The subjects were 17 patients who had been dialyzed with VPS-HA for 12 months. The subjects’ baseline characteristics were as follows. Their average age was 65.6 ± 13.1 years, comprising 8 males and 9 females; hemodialysis vintage was 83.8 ± 85.4 months. Eight had chronic glomerular nephropathy and five had diabetic nephropathy. The primary outcome was defined as alpha (1) antitrypsin–LDL complex level after 12 months, as a post-study using VPS-HA. Secondary outcomes included triglycerides, total cholesterol, HDL cholesterol and LDL cholesterol levels. The data were analyzed pre-study and after 3, 6, 9 and 12 months for alpha (1) antitrypsin–LDL complex, and pre-study and post-study for the other indicators. Twelve months after switching to VPS-HA, alpha (1) antitrypsin–LDL complex, total cholesterol and LDL cholesterol had significantly decreased. Triglycerides and HDL cholesterol had not significantly changed. Hemodialysis therapy with VPS-HA was shown to decrease alpha (1) antitrypsin–LDL complex, an index of oxidative stress, and also to decrease some lipid markers.

Highlights

  • Few studies have identified this effect with vitamin E-bonded polysulfone membranes, and no studies report the same effect on alpha (1) antitrypsin–LDL complex, a new oxidative lipid marker

  • This prompted us to examine the influence of use of VPS-HA vitamin E-bonded polysulfone high-flux membrane dialyzers on this new oxidative lipid marker

  • An overview of regular dialysis treatment in Japan as of 31 December 2008 reported by the Japanese Society for Dialysis Therapy showed that more than half of hemodialysis patients were being dialyzed with high-flux polysulfone (PS) membrane [1]

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Summary

Introduction

An overview of regular dialysis treatment in Japan as of 31 December 2008 reported by the Japanese Society for Dialysis Therapy showed that more than half of hemodialysis patients were being dialyzed with high-flux polysulfone (PS) membrane [1]. Recent reports suggest alpha (1) antitrypsin (AT) lowdensity lipoprotein complex [alpha (1) AT–LDL complex] [3], which promotes arteriosclerosis, to be implicated in oxidative LDL in circulatory system diseases. Alpha (1) AT–LDL complex is comprised of alpha (1) AT and LDL cholesterol and appears to be a type of oxidative LDL that. Alpha (1) AT–LDL complex may be a useful marker of arteriosclerosis. It has been reported that activation of complements, discharge of granulocytic elastase, lipid peroxidation of red blood cell membranes, production of oxidative LDL and coagulation in the dialyzer are suppressed when using vitamin E-bonded membrane dialyzers [4,5,6,7]. Few patients dialyzed with vitamin E-bonded membrane dialyzers have been studied, and their clinical effectiveness is unknown

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