Document Detail


Effect of synthetic vitamin E-bonded membrane on responsiveness to erythropoiesis-stimulating agents in hemodialysis patients: a pilot study.
MedLine Citation:
PMID:  20215781     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Oxidative stress, a recently identified factor related to the response to erythropoiesis-stimulating agents (ESAs), is increased in hemodialysis patients. The aim of this study was to verify whether ESA responsiveness improves if the anti-oxidant vitamin E (Vi-E) is placed on the blood-side layer of a synthetic polysulfone (PS) dialyzer. METHODS: This 8-month, controlled and open randomized study involved 2 groups of patients on stable ESA therapy undergoing hemodialysis using a PS dialyzer with or without Vi-E treatment. Hemoglobin, albumin, high-sensitivity C-reactive protein, interleukin-6, iron status, parathyroid hormone (PTH), Vi-E (alpha- and gamma-tocopherol levels) and the oxidative stress markers, advanced oxidation protein products, carbonyls and advanced glycation end products were evaluated every 2 months. The primary outcome measure was ESA resistance, the weekly ESA dose divided by the product between hemoglobin level and end-dialysis body weight. RESULTS: Nineteen of the 20 randomized patients completed the study. During the follow-up, the ESA resistance significantly decreased (p = 0.024), greater in the Vi-E group (37%) than in the PS group (20%), but this difference was not statistically significant (p = 0.596). Baseline PTH and Vi-E levels were associated with ESA resistance. In the secondary analysis, including these covariates in the model, the difference between groups in ESA resistance became significant (p = 0.042). CONCLUSIONS: Vi-E placed on the blood-side of a dialyzer may have a possible beneficial effect on ESA resistance in hemodialysis patients; baseline PTH levels seem to predict ESA resistance and were useful in showing the possible beneficial effect of Vi-E and should be considered in designing adequate-sized trials for testing this hypothesis.
Authors:
Simeone Andrulli; Salvatore Di Filippo; Celestina Manzoni; Luca Stefanelli; Alessandro Floridi; Francesco Galli; Francesco Locatelli
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2010-03-08
Journal Detail:
Title:  Nephron. Clinical practice     Volume:  115     ISSN:  1660-2110     ISO Abbreviation:  Nephron Clin Pract     Publication Date:  2010  
Date Detail:
Created Date:  2010-04-30     Completed Date:  2010-08-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101159763     Medline TA:  Nephron Clin Pract     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  c82-9     Citation Subset:  IM    
Affiliation:
Department of Nephrology, Dialysis and Renal Transplantation, A. Manzoni Hospital, Lecco, Italy.
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MeSH Terms
Descriptor/Qualifier:
Aged
Anemia / etiology*,  prevention & control*
Antioxidants / administration & dosage
Drug Therapy, Combination
Female
Hematinics / administration & dosage*
Humans
Male
Middle Aged
Pilot Projects
Renal Dialysis / adverse effects*
Treatment Outcome
Vitamin E / administration & dosage*
Chemical
Reg. No./Substance:
0/Antioxidants; 0/Hematinics; 1406-18-4/Vitamin E

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


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