Document Detail


Does hemodiafiltration improve the removal of homocysteine?
MedLine Citation:
PMID:  22111820     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
High prevalence of hyperhomocysteinemia is common in hemodialysis (HD) patients and could contribute to worsen the cardiovascular risk. Beyond vitamin B status, dialysis modality itself could influence homocysteine (Hcy) levels. The objective was compare the reduction rate (RR) of Hcy and cysteine in stable dialyzed patients treated by standard HD or hemodiafiltration (HDF). Seventy-five patients undergoing stable dialysis through standard high-flux HD (n = 35) or HDF (n = 40) were included. Biological parameters were determined before and after a midweek dialysis session. Urea percent reduction per session and Kt/V index (K, body urea clearance, T, time of dialysis, and V, urea distribution volume), defined as a marker of dialysis efficacy, were similar between HD and HDF groups. By contrast, higher RR of beta2 microglobulin (β2m) was observed in HDF compared with HD (78.6 vs. 72.0%, respectively; P < 0.001). Likewise, higher RR of Hcy was obtained with HDF compared to HD (46.0 vs. 41.5%, respectively; P < 0.05), whereas the RR of cysteine was similar in both groups. Interestingly, a positive correlation between Hcy RR and urea Kt/V index was observed (r = 0.29, P < 0.05) and between Hcy RR and β2m RR (r = 0.45, P < 0.001). Time-averaged concentration (TAC) of Hcy was lower with HDF compared with HD (17.8 vs. 19.1 μmol/L, respectively), although not significant. There was no difference in median Hcy according to dialysis modality for neither pre- nor postdialysis levels. Significant higher removal of Hcy was observed with HDF compared with standard HD, although urea Kt/V index was similar. Enhanced removal of middle molecules, such as β2m, could be involved in Hcy RR improvement with HDF.
Authors:
Stéphanie Badiou; Marion Morena; Anne-Sophie Bargnoux; Isabelle Jaussent; Annie Rodriguez; Helene Leray-Moragues; Lofti Chalabi; Jean-Yves Bosc; Bernard Canaud; Jean-Paul Cristol
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-14
Journal Detail:
Title:  Hemodialysis international. International Symposium on Home Hemodialysis     Volume:  15     ISSN:  1542-4758     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-11-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101093910     Medline TA:  Hemodial Int     Country:  -    
Other Details:
Languages:  ENG     Pagination:  515-521     Citation Subset:  -    
Copyright Information:
© 2011 The Authors; Hemodialysis International © 2011 International Society for Hemodialysis.
Affiliation:
Laboratoire de Biochimie, CHU Montpellier, Université Montpellier, Montpellier, France; UMR 204, Nutripass, Université Montpellier, Montpellier, France.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Does online hemodiafiltration lead to reduction in trace elements and vitamins?
Next Document:  Dialysate saving by automated control of flow rates: Comparison between individualized online hemodi...