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Prospective randomized pilot study on the effects of two synthetic high-flux dialyzers on dialysis patient anemia.
MedLine Citation:
PMID:  22684617     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Purpose: Anemia in chronic kidney disease dialysis patients is a complex syndrome involving many causes. Adequate dialysis can contribute to its correction through many mechanisms, including the removal of molecules that may inhibit erythropoiesis. The aim of this pilot study was to evaluate the effect on renal anemia of two synthetic, high-flux dialyzers (polynephron vs. high-flux polysulphone). Methods: 20 dialysis patients (11 male; mean age: 72 years) were randomly assigned and studied for 6 months. There were 2 dropouts in each group. Each patient underwent 3 hemodialysis treatments per week without any difference in dialysis prescription. At T = 0 and T = 6 (after 6 months), instantaneous plasma clearances and reduction rates of small solutes, ß2-microglobulin protein (ß2-µ); hemoglobin (Hb), and iron pattern were measured. The effect on anemia was evaluated by calculating the Erythropoesis Stimulating Agent (ESA) doses and the Erythropoietin Resistance Index (ERI). Results: Kt/V increased between T0 and T6 in both groups. ß2-µ pre-dialysis levels significantly decreased between T0 and T6 in both dialyzer groups (p<0.001 in both groups). The Hb levels increased between T0 and T6, but significantly only for the polynephron patient group (p = 0.006 and 0.142). ESA dose did not change significantly. The ERI decreased by 22.7% between T0 and T6 in the polynephron-group and increased by 14% in the others; these changes were not significant. Conclusions: High-flux filters improved Hb levels, although only significantly in the polynephron group, suggesting a possible different effect. The results should be interpreted with caution and tested in an appropriately powered, large, prospective, randomized control trial.
Authors:
Sara M Viganò; Salvatore Di Filippo; Vincenzo La Milia; Giuseppe Pontoriero; Francesco Locatelli
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The International journal of artificial organs     Volume:  35     ISSN:  1724-6040     ISO Abbreviation:  Int J Artif Organs     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-06-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802649     Medline TA:  Int J Artif Organs     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  346-51     Citation Subset:  IM    
Affiliation:
Department of Nephrology, Dialysis and Renal Transplant, Alessandro Manzoni Hospital, Lecco - Italy.
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