Impact of Low- or High-Flux Haemodialysis and Online Haemodiafiltration on Inflammatory Markers and Lipid Profile in Chronic Haemodialysis Patients

Abstract

Background/Aims: We aimed to evaluate the impact of low- or high-flux haemodialysis (HD) and online haemodiafiltration (OL-HDF) on inflammation and the lipid profile in HD patients. Methods: 50 HD patients were assigned to two groups for HD with low-flux (n = 25) or high-flux (n = 25) polysulphone dialysers for 6 weeks. Subsequently, all patients were haemodialysed with a low-flux polysulphone dialyser for 6 weeks, then transferred to OL-HDF for another 6 weeks. Blood samples for lipids and inflammatory markers (IL-6, IL-8, TNF-α, hs-CRP) were obtained at baseline and every 6 weeks. Results: Changes in inflammatory markers and lipids from baseline to the 6-week dialysis period did not differ between low- and high-flux groups. When patients were transferred from low-flux HD to OL-HDF, IL-6, IL-8, and TNF-α levels significantly decreased whereas HDL and LDL cholesterol significantly increased. Conclusion: Low- and high-flux polysulphone membranes had similar effects on lipids and inflammatory markers, whereas OL-HDF potently reduced pro-inflammatory cytokines.

Improving Erythropoiesis Stimulating Agent Hyporesponsiveness in Hemodialysis Patients: The Role of Hepcidin and Hemodiafiltration Online

“…The reduction on IL-6 of is a common finding with OL-HDF techniques. Among these observations, Akoglu et al [47] demonstrated a significant reduction of IL-6 levels on OL-HDF whereas HD with low- and high-flux polysulfone membranes did not obtain any effect on IL-6 level.…”

Could there be Haemodynamic Stress Effects on Pro-Inflammatory CD14+CD16+ Monocytes during Convective-Diffusive Treatments? A Prospective Randomized Controlled Trial

“…However, this was not sufficient to decrease monocyte activation as it has been shown in the post-hoc analysis of CONTRAST study; this polycentric study showed a less pro-inflammatory effect with a lower level of hsCRP, IL-6 and albumin in OL-HDF than standard HD [31]. Another study from Akoglu et al [27] showed that patients treated with OL-HDF presented lower levels of hsCRP, IL-8, and TNF-α respect to highefficiency HD.…”

“…Furthermore, it is very remarkable that in both treatments they used acetate in dialytic fluids. Unfortunately, Akoglu et al [27] did not use homogenous devices and membranes and acetate dialysate was instead used. It is well known that acetate has a stimulating effect on inflammatory pathway and yields to pro-oxidant results, which in turn results in a confounding factor.…”

The Relationship Between Hemodialysis Modality and Insulin Resistance in Non-Diabetic Hemodialysis Patients

“…Some reports showed that online HDF can increase HDL-cholesterol levels and decrease TG levels by approximately 15% [22,23]. Additionally, adipokines such as serum leptin and adiponectin concentrations can be influenced by dialysis modalities and membrane permeability [24].…”