Vitamin E‑coated dialyzer alleviates erythrocyte deformability dysfunction in patients with end‑stage renal disease undergoing hemodialysis

Abstract

Patients with end-stage renal disease (ESRD) are characterized by augmented oxidative stress (OS) due to the imbalance between the generation of increased concentrations of oxidative molecules and decreased antioxidant capacity. Vitamin E-coated dialyzer membranes (VEMs) have previously been reported to alleviate the imbalance of redox metabolism in patients with ESRD undergoing hemodialysis (HD); however, their effect on the deformability of red blood cells (RBCs) remains unknown. In the present study, 48 patients with ESRD undergoing HD were enrolled and randomly assigned into two groups: HD with VEMs (VEM group; n=24) and HD with polysulfone dialyzer membranes (PM group; n=24), and another 24 healthy volunteers served as the control group. The present study investigated the morphological changes and deformability of RBCs in patients with ESRD and healthy volunteers. The concentration of serum vitamin E, the parameters of antioxidant stress and OS, and the degree of oxidative phosphorylation and clustering of anion exchanger 1 (Band 3) in RBCs were measured. The results obtained suggested that VEM treatment markedly ameliorated the abnormalities of RBC morphology and deformability in patients with ESRD undergoing HD. Mechanistic studies showed that VEM treatment led to a marked improvement in the concentration of serum vitamin E, which was positively associated with the restored antioxidant capacity, and decreased oxidative phosphorylation and clustering of Band 3 in RBCs of patients with ESRD undergoing HD. Taken together, the results of the present study have demonstrated that VEM treatment effectively restored the imbalance of redox metabolism, and improved the oxidative phosphorylation and clustering of Band 3 in RBCs of patients with ESRD undergoing HD via delivering vitamin E, which may alleviate the abnormal morphological and mechanical properties of RBCs. These findings are anticipated to be useful with respect to improving the nursing care and cure rate of patients with ESRD.

Beneficial and adverse effects of vitamin E on the kidney

“…In a recent dose-response study of Zhang et al (2022) in patients with end-stage renal disease, it was found that higher levels of serum vitamin E resulted in a higher anti-oxidant status and a consequently lower oxidative stress as measured by the total reactive oxygen species.…”

Alleviation of Oxidative Stress during Hemodialysis Sessions by Hemodialysis Membrane Innovation: A Multidisciplinary Perspective

“…As discussed above, vitamin E-coated membranes can significantly scavenge ROS and improve total antioxidant status as well as red blood cell antioxidant status in dialysis patients [18]. Growing evidence also shows that vitamin E-coated membranes can prolong erythrocyte lifespan, reduce erythrocyte fragility, and alleviate erythrocyte deformability dysfunction during hemodialysis [19, 20]. Accordingly, several clinical studies have been conducted to investigate whether vitamin E-coated membranes could improve anemia in patients receiving long-term hemodialysis.…”

Vitamin E Treatment Improves the Antioxidant Capacity of Patients Receiving Dialysis: A Systematic Review and Meta‐Analysis

“…Twenty-four experimental studies involving 512 patients receiving dialysis were selected for the meta-analysis, including 16 non-RCTs [14][15][16][17][18][19][21][22][23][24][25]27,28,30,32,35] and 8 RCTs. [20,26,29,31,33,34,36,37] Fourteen studies were related to the treatment results of patients receiving HD and VEMs. [15,[17][18][19][20]22,24,25,27,30,32,33,35,37] The study population included participants from Europe, [15,17,18,20,24,27,30,32,33,35] Asia [25,37] and Oceania.…”

“…[20,26,29,31,33,34,36,37] Fourteen studies were related to the treatment results of patients receiving HD and VEMs. [15,[17][18][19][20]22,24,25,27,30,32,33,35,37] The study population included participants from Europe, [15,17,18,20,24,27,30,32,33,35] Asia [25,37] and Oceania. [19,22] The intervention duration varied from 3 weeks to 6 months.…”