Vitamins (A, C and E) and oxidative status of hemodialysis patients treated with HFR and HFR-Supra

BMC Nephrology

Research Article

Tonina Ghisu¹  Giuseppe Palladino²  Simonetta Palleschi³  Barbara Rossi³  Paolo M. Ghezzi⁴  Marino Ganadu⁵  Domenica Casu⁶  Alessandro Amore⁷  Bruno Contu⁸  Maria Cristina Mereu⁹  Mario Passaghe^1,10  Luana Gazzanelli^1,11  Giovanni Mattana^1,12  Franco Logias^1,12  Antonio Maria Pinna^1,13  Maria Cossu^1,14  Alessandro Monni^1,15  Piergiorgio Bolasco^1,16 

[1]ASL 3, Macomer, Italy

[2]Bellco s.r.l Company, Mirandola, Italy

[3]Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy

[4]Medical Scientific Consultant of Bellco s.r.l. Company, Mirandola, Italy

[5]Ospedale A.Segni, Ozieri, Italy

[6]Ospedale Civile, Alghero, Italy

[7]Ospedale Infantile Regina Margherita, Torino, Italy

[8]Ospedale N.S. della Mercede, Lanusei, Italy

[9]Ospedale N.S. di Bonaria, S. Gavino Monreale, Italy

[10]Ospedale P. Dettori, Tempio Pausania, Italy

[11]Ospedale P. Merlo, La Maddalena, Italy

[12]Ospedale S. Francesco, Nuoro, Italy

[13]Ospedale S. Martino, Oristano, Italy

[14]Ospedale SS. Annunziata, Sassari, Italy

[15]Ospedale SS. Trinità, Cagliari, Italy

[16]Territorial Unit of Nephrology and Dialysis , ASL 8 of Cagliari, Cagliari, Italy

关键词: Oxidative stress;    Hemodiafiltration;    Antioxidants;    Vitamins;    Adsorption;    HFR;    High permeability;   

DOI  :  10.1186/s12882-016-0315-6

 received in 2016-01-20, accepted in 2016-07-19,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundHemodiafiltration with on-line endogenous reinfusion (HFR) is an extracorporeal dialytic method that combines diffusion, convection and adsorption. HFR-Supra (HFR-S) is a second-generation system with increased convective permeability and adsorption capability. Previous studies suggested that HFR reduces oxidative stress compared to standard haemodialysis. The principal aim of the present study was to compare antioxidant vitamins behavior and oxidative status of hemodialysis patients treated with HFR and HFR-S.MethodsThe study was designed as a multicenter, randomized, crossover trial. Forty-one patients were recruited from 19 dialysis centers and after a 4-month washout stabilization period in on-line hemodiafiltration (ol-HDF), each patient was randomized to a sequence of treatments (HFR-S followed by HFR or viceversa) with each treatment applied over 6 months. Plasma levels of Advanced Oxidation Protein Products, Total Antioxidant Status, vitamins C, A and E and their ligands (Retinol Binding Protein and total lipids) were measured at baseline and at the end of each treatment period.ResultsResults show that the higher convective permeability of HFR-S with respect to HFR did not produce additional beneficial effects on the patients’ oxidative status, a slight decrease of both Vitamin A and Retinol Binding Protein being the only difference registered in the long-term. However, as compared to ol-HDF, both the re-infusive techniques allowed to reduce the intradialytic loss of Vitamin C and, in the long-term, improve the patients’ oxidative status and increase Retinol Binding Protein plasma values. No significant differences were found between the Vitamin C concentration of pre- and post cartridge UF neither in HFR-S nor in HFR showing that the sorbent resin does not adsorb Vitamin C.ConclusionHFR-S and HFR are almost equivalent in term of impact on antioxidant vitamins and oxidative status of hemodialysis patients. Nonetheless, as compared to ol-HDF, both treatments produced a sensible sparing of Vitamin C and may represent a new approach for reducing oxidative stress and related complications in dialysis patients. Long-term effects of re-infusive treatments on patients’ cardiovascular morbidity and mortality need to be evaluated.Trial registrationClinicalTrials.gov Identifier NCT01492491, retrospectively registered in 10 December 2011.

【 授权许可】

CC BY   
© The Author(s). 2016