A Retrospective Study on Erythropoiesis Stimulating Agent Dose Reducing Potential of an Anti‐Platelet Activation Membrane Dialyzer in Hemodialysis Patients

Kakuta, Tsunekazu; Ishida, Mari; Komaba, Hirotaka; Suzuki, Hajime; Fukagawa, Masafumi

doi:10.1111/1744-9987.12759

Ther Apher Dial

2018

DOI: 10.1111/1744-9987.12759

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A Retrospective Study on Erythropoiesis Stimulating Agent Dose Reducing Potential of an Anti‐Platelet Activation Membrane Dialyzer in Hemodialysis Patients

Tsunekazu Kakuta

Mari Ishida

Hirotaka Komaba

et al.

Abstract: Our previous small‐scale trial demonstrated an erythropoiesis stimulating agent (ESA)‐sparing potential of the TORAYLIGHT NV (NV) dialyzer in hemodialysis patients with high interleukin‐6 levels. We now retrospectively explored this ESA‐sparing potential of the NV dialyzer in 122 and 129 prevalent dialysis patients who were on the NV and conventional polysulfone (PS) dialyzers, respectively, for 12 months. ESA resistance index (ERI) increased with the PS dialyzers whereas neither ERI nor ESA dose changed with … Show more

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Cited by 3 publications

References 28 publications

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Flexible inner surface of polysulfone membranes prevents platelet adhesive protein adsorption and improves antithrombogenicity in vitro

Takatsuji,

Koremoto,

Fujimoto

et al. 2024

Int J Artif Organs

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Background: We investigated whether the condition of the inner surface of hollow fibers affects the blood compatibility of hemodialyzers. Methods: We used scanning probe microscope/atomic force microscopy (SPM/AFM) to investigate the height of the swelling and flexible layers (thickness and softness) on the inner surfaces of the hollow fibers. Next, we tested the blood compatibility between dialyzers comprising a hollow fiber membrane, in which the other dialyzers, except for PVP, were additionally coated using PS membranes coated with other materials. After blood was injected into the dialyzer and plugged, dynamic stimulation was performed by slightly rotating the dialyzer for 4 h, although there was no blood circulation. Results: The vitamin E-coated polysulfone (PS) membrane showed a higher thickness and softness of the flexible layer than the asymmetric cellulose triacetate membrane without polyvinylpyrrolidone (PVP) and the PS membranes with PVP. We found that the dialyzer with vitamin E coating significantly suppressed the decrease in platelets, increase in β-TG, and increase in PF4 compared to those coated with NV polymer. Additionally, as the adsorbed protein on the inner surface, the total protein, fibronectin, and vWF levels were significantly lower in the vitamin E-coated dialyzer. Conclusion: The thickness and softness of the flexible layer of the inner surface of the hollow fiber membrane in vitro affect differences in blood coagulation performance in clinical research. Future clinical trials are required to confirm our results.

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Flexible inner surface of polysulfone membranes prevents platelet adhesive protein adsorption and improves antithrombogenicity in vitro

Takatsuji,

Koremoto,

Fujimoto

et al. 2024

Int J Artif Organs

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Estimated influence of a novel biocompatible dialysis membrane on vascular events in dialysis patients with diabetic nephropathy: a prospective randomized controlled pilot study

et al. 2020

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Background Polysulfone (PS) dialyzers are most frequently used worldwide for chronic renal failure patients and they are produced by several manufacturers. Despite using the same materials, differences in biocompatibility among PS dialyzers have been reported. TORAYLIGHT NV (NV) is a PS dialyzer that was reported to have superior biocompatibility compared with other PS membranes (conventional PS membranes). Therefore, we examined whether biocompatibility of PS membranes would affect the occurrence of cardiovascular events in hemodialysis patients with diabetic nephropathy (DN). Methods Fifty hemodialysis patients with DN were enrolled. They were randomly divided into NV and PS groups and then followed up for 3 years. The number of patients who developed cardiovascular events and clinical data including laboratory tests and blood pressure was recorded. Results There were 13 and 14 patients who developed cardiovascular events during the 3-year follow-up of the NV and PS groups, respectively. There was no significant difference between the groups. There were no significant differences in most of the clinical data between the two groups. However, serum pentosidine concentrations in the PS group significantly increased throughout this study, while those in the NV group did not change. Additionally, the width of the systolic blood pressure drop, which was shown to be the difference between before and after dialysis session, in the PS group showed no change, while that in the NV group tended to decrease. Conclusions The superiority of using NV membrane compared with conventional PS membranes in reducing cardiovascular events in hemodialysis patients with DN remains unclear. However, our results suggested that PS membranes with superior biocompatibility would slow the progression of atherosclerosis and reduce the occurrence of intradialytic hypotension. Trial registration This study was retrospectively registered with the Clinical Trials Registry at the University Hospital Medical Information Network (UMIN-CTR) on March 17, 2017 (registration ID, UMIN 000026339). https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&recptno=R000030259&type=summary&language=J

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Biocompatibility of Surface-Modified Membranes for Chronic Hemodialysis Therapy

et al. 2022

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Hemodialysis is a life-sustaining therapy for millions of people worldwide. However, despite considerable technical and scientific improvements, results are still not fully satisfactory in terms of morbidity and mortality. The membrane contained in the hemodialyzer is undoubtedly the main determinant of the success and quality of hemodialysis therapy. Membrane properties influence solute removal and the interactions with blood components that define the membrane’s biocompatibility. Bioincompatibility is considered a potential contributor to several uremic complications. Thus, the development of more biocompatible polymers used as hemodialyzer membrane is of utmost importance for improving results and clinical patient outcomes. Many different surface-modified membranes for hemodialysis have been manufactured over recent years by varying approaches in the attempt to minimize blood incompatibility. Their main characteristics and clinical results in hemodialysis patients were reviewed in the present article.

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A Retrospective Study on Erythropoiesis Stimulating Agent Dose Reducing Potential of an Anti‐Platelet Activation Membrane Dialyzer in Hemodialysis Patients

Cited by 3 publications

References 28 publications

Flexible inner surface of polysulfone membranes prevents platelet adhesive protein adsorption and improves antithrombogenicity in vitro

Flexible inner surface of polysulfone membranes prevents platelet adhesive protein adsorption and improves antithrombogenicity in vitro

Estimated influence of a novel biocompatible dialysis membrane on vascular events in dialysis patients with diabetic nephropathy: a prospective randomized controlled pilot study

Biocompatibility of Surface-Modified Membranes for Chronic Hemodialysis Therapy

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