Relation of middle molecules levels and oxidative stress to erythropoietin requirements in high-flux versus low-flux hemodialysis

El-Wakil, Hala S; Abou-Zeid, Abla A.; El-Gohary, Iman E; El-Seoud, Nahla A Abou

doi:10.4103/1319-2442.118082

Cited by 3 publications

(3 citation statements)

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“…Similar to the present study, there have been reports that AOPP levels are decreased by dialysis, while other reports have indicated that dialysis increases AOPP levels by inducing protein damage via reactive oxygen species. [40][41][42] Therefore, further studies are warranted. The vitamin E-coated membrane also exhibited reduced fibrinogen adhesion on POD 1.…”

Section: Discussionmentioning

confidence: 99%

A chronic intermittent haemodialysis pig model for functional evaluation of dialysis membranes

Yamamoto,

Umeno,

Sano

et al. 2024

Int J Artif Organs

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Performance evaluation of new dialysis membranes is primarily performed in vitro, which can lead to differences in clinical results. Currently, data on dialysis membrane performance and safety are available only for haemodialysis patients. Herein, we aimed to establish an in vivo animal model of dialysis that could be extrapolated to humans. We created a bilateral nephrectomy pig model of renal failure, which placed a double-lumen catheter with the hub exposed dorsally. Haemodialysis was performed in the same manner as in humans, during which clinically relevant physiologic data were evaluated. Next, to evaluate the utility of this model, the biocompatibility of two kinds of membranes coated with or without vitamin E used in haemodiafiltration therapy were compared. Haemodialysis treatment was successfully performed in nephrectomized pigs under the same dialysis conditions (4 h per session, every other day, for 2 weeks). In accordance with human clinical data, regular dialysis alleviated renal failure in pigs. The vitamin E-coated membrane showed a significant reduction rate of advanced oxidation protein products during dialysis than non-coated membrane. In conclusion, this model mimics the pathophysiology and dialysis condition of patients undergoing haemodialysis. This dialysis treatment model of renal failure will be useful for evaluating the performance and safety of dialysis membranes.

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Section: Discussionmentioning

confidence: 99%

A chronic intermittent haemodialysis pig model for functional evaluation of dialysis membranes

Yamamoto,

Umeno,

Sano

et al. 2024

Int J Artif Organs

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“…High-flux dialysis may improve patient hemoglobin levels through improved clearance of moderate- and high-molecular-weight toxins [ 40 ]. The average weekly dose of human recombinant erythropoietin required to maintain target hemoglobin levels on high-flux dialysis is lower than the average dose needed in patients on low-flow dialysis [ 41 ]. In addition, a randomized prospective study revealed that patients on high-flux dialysis had a significantly greater rate of goal Hb attainment than did those in the low-flux group, and high-flux dialysis was beneficial for maintaining stable hemoglobin levels [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of low-flux and high-flux hemodialysis on the survival of elderly maintenance hemodialysis patients

Huang,

Bai,

Zhang

et al. 2024

Renal Failure

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Background Elderly hemodialysis (HD) patients have a high risk of death. The effect of different types of HD membranes on survival is still controversial. The purpose of this study was to determine the relationship between the use of low-flux or high-flux membranes and all-cause and cardiovascular mortality in elderly hemodialysis patients. Methods This was a retrospective clinical study involving maintenance hemodialysis patients which were categorized into low-flux and high-flux groups according to the dialyzer they were using. Propensity score matching was used to balance the baseline data of the two groups. Survival rates were compared between the two groups, and the risk factors for death were analyzed by multivariate Cox regression. Results Kaplan–Meier survival analysis revealed no significant difference in all-cause mortality between the low-flux group and the high-flux group (log-rank test, p = 0.559). Cardiovascular mortality was significantly greater in the low-flux group than in the high-flux group (log-rank test, p = 0.049). After adjustment through three different multivariate models, we detected no significant difference in all-cause mortality. Patients in the high-flux group had a lower risk of cardiovascular death than did those in the low-flux group (HR = 0.79, 95% CI, 0.54–1.16, p = 0.222; HR = 0.58, 95% CI, 0.37–0.91, p = 0.019). Conclusions High-flux hemodialysis was associated with a lower relative risk of cardiovascular mortality in elderly MHD patients. High-flux hemodialysis did not improve all-cause mortality rate. Differences in urea distribution volume, blood flow, and systemic differences in solute clearance by dialyzers were not further analyzed, which are the limitations of this study.

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“…The last group of toxins consists of middle molecules. Similar to the previous groups, they may cause various biochemical and metabolic disorders, which will intensify the inflammation and damage the blood vessel wall [20]. Glorieux et al [21] investigated the serum beta2-microglobulin (B2MG) and advanced oxidation protein products (AOPP) as middle molecule uremic toxins and protein carbonyl (PCO) as oxidative stress marker in uremic patients undergoing high-flux versus low-flux hemodialysis (HD).…”

Section: Uremic Toxins and Ckdmentioning

confidence: 91%

Renal Replacement Modality Affects Uremic Toxins and Oxidative Stress

Niemczyk

Małyszko

2021

Oxidative Medicine and Cellular Longevity

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Nowadays, the high prevalence of kidney diseases and their related complications, including endothelial dysfunction and cardiovascular disease, represents one of the leading causes of death in patients with chronic kidney diseases. Renal failure leads to accumulation of uremic toxins, which are the main cause of oxidative stress development. The renal replacement therapy appears to be the best way to lower uremic toxin levels in patients with end-stage renal disease and reduce oxidative stress. At this moment, despite the increasing number of recognized toxins and their mechanisms of action, it is impossible to determine which of them are the most important and which cause the greatest complications. There are many different types of renal replacement therapy, but the best treatment has not been identified yet. Patients treated with diffusion methods have satisfactory clearance of small molecules, but the clearance of medium molecules appears to be insufficient, but treatment with convection methods cleans medium molecules better than small molecules. Hence, there is an urgent need of new more validated, appropriate, and reliable information not only on toxins and their role in metabolic disorders, including oxidative stress, but also on the best artificial renal replacement therapy to reduce complications and prolong the life of patients with chronic kidney disease.

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Relation of middle molecules levels and oxidative stress to erythropoietin requirements in high-flux versus low-flux hemodialysis

Cited by 3 publications

References 0 publications

A chronic intermittent haemodialysis pig model for functional evaluation of dialysis membranes

A chronic intermittent haemodialysis pig model for functional evaluation of dialysis membranes

Effects of low-flux and high-flux hemodialysis on the survival of elderly maintenance hemodialysis patients

Renal Replacement Modality Affects Uremic Toxins and Oxidative Stress

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