Dialysis filter type determines the acute effect of haemodialysis on endothelial function and oxidative stress

• Published in: Nephrology, dialysis, transplantation dialysis, transplantation, 2003-07, Vol.18 (7), p.1370-1375
• Main Authors: Kosch, Markus, Levers, Andrea, Fobker, Manfred, Barenbrock, Michael, Schaefer, Roland M., Rahn, Karl‐Heinz, Hausberg, Martin
• Format: Article
• Language: English
• Subjects: Acute Disease; Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biocompatible Materials - therapeutic use; Biological and medical sciences; Brachial Artery - physiopathology; Cardiovascular Diseases - etiology; Cardiovascular Diseases - physiopathology; Cardiovascular Diseases - prevention & control; Cellulose - analogs & derivatives; Cellulose - therapeutic use; Cross-Over Studies; cuprophane; Double-Blind Method; Emergency and intensive care: renal failure. Dialysis management; endothelial function; Endothelium, Vascular - physiopathology; Female; flow‐mediated vasodilatation; haemodialysis; Humans; Intensive care medicine; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - physiopathology; Kidney Failure, Chronic - therapy; Male; Medical sciences; Membranes, Artificial; Middle Aged; oxidative stress; Oxidative Stress - physiology; Polymers - therapeutic use; polysulphone; Renal Dialysis - adverse effects; Sulfones - therapeutic use
• ISSN: 0931-0509; 1460-2385
• DOI: 10.1093/ndt/gfg169

Background. Endothelial function of large arteries is impaired in chronic haemodialysis patients and oxidative stress due to the dialysis procedure has been suggested as a causal factor. However, it is not clear whether different types of dialysis membranes affect endothelial function differently. Therefore we determined endothelium‐dependent, flow‐mediated dilatation (FMD) of the brachial artery as well as markers of oxidative stress immediately before and after haemodialysis (HD) with either a cellulosic cuprophane or a synthetic polysulphone dialyser in a blinded, randomized, cross‐over study. Methods. Twelve haemodialysis patients (age 55±3 years, time on dialysis 20±2 months, mean fluid change −1782±21 ml, systolic/diastolic blood pressure 139/75 mmHg) were included. Using a multi‐gate‐pulsed Doppler system (echo‐tracking device) brachial artery FMD and nitroglycerine‐induced, endothelium‐independent vasodilatation (NMD) were measured. Patients were randomized to HD with either a polysulphone or a cuprophane membrane and were crossed over to the other filter. Investigators were blinded to the type of membrane used. Serum concentrations of oxidized LDL (oxLDL) and α‐tocopherol as markers of oxidative stress were measured before and after each dialysis session. Results. Data are given as mean±SEM. Treatment with polysulphone filter HD did not significantly affect FMD (baseline 9.3±2.0% vs after HD 9.6±1.8%). After dialysis with a cuprophane membrane FMD decreased from 9.4±2.1 to 7.4±1.8% (P