| Effect of synthetic vitamin E-bonded membrane on responsiveness to erythropoiesis-stimulating agents in hemodialysis patients: a pilot study. | |
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MedLine Citation:
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PMID: 20215781 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Simeone Andrulli; Salvatore Di Filippo; Celestina Manzoni; Luca Stefanelli; Alessandro Floridi; Francesco Galli; Francesco Locatelli |
Publication Detail:
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Type: Journal Article; Randomized Controlled Trial Date: 2010-03-08 |
Journal Detail:
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Title: Nephron. Clinical practice Volume: 115 ISSN: 1660-2110 ISO Abbreviation: Nephron Clin Pract Publication Date: 2010 |
Date Detail:
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Created Date: 2010-04-30 Completed Date: 2010-08-05 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101159763 Medline TA: Nephron Clin Pract Country: Switzerland |
Other Details:
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Languages: eng Pagination: c82-9 Citation Subset: IM |
Affiliation:
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Department of Nephrology, Dialysis and Renal Transplantation, A. Manzoni Hospital, Lecco, Italy. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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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