BACKGROUND AND OBJECTIVES: Hemodialysis treatment induces markers of inflammation and oxidative stress, which could affect hemoglobin levels and the response to erythropoietin use. This study sought to determine whether high-flux dialysis would help improve markers of renal anemia, inflammation, and oxidative stress compared with low-flux dialysis. DESIGN, SETTINGS, PARTICIPANTS, & MEASUREMENTS: In a prospective, controlled study, 221 patients undergoing maintenance hemodialysis and receiving darbepoetin-alfa treatment (mean age, 66 years; 55% male) from 19 centers were screened in a 20-week run-in period of low-flux hemodialysis with a synthetic dialysis membrane. Thereafter, 166 patients were enrolled and randomly assigned to receive a synthetic high-flux membrane or to continue on low-flux dialysis for 52 weeks. Data on myeloperoxidase, oxidized LDL, high-sensitivity C-reactive protein, and the Malnutrition Inflammation Score were collected at baseline and after 52 weeks; routine laboratory data, such as hemoglobin, ferritin, and albumin, and the use of darbepoetin-alfa, were also measured in the run-in period. Results After 52 weeks, the low-flux and the high-flux groups did not differ with respect to hemoglobin (mean ± SD, 11.7±0.9 g/dl versus 11.7±1.1 g/dl; P=0.62) or use of darbepoetin-alfa (mean dosage ± SD, 29.8±24.8 μg/wk versus 26.0±31.1 μg/wk; P=0.85). Markers of inflammation, oxidative stress, or nutritional status also did not differ between groups. CONCLUSION: Over 1 year, high-flux dialysis had no superior effects on hemoglobin levels or markers of inflammation, oxidative stress, and nutritional status. These data do not support the hypothesis that enhanced convective toxin removal would improve patient outcome.
RCT Entities:
BACKGROUND AND OBJECTIVES: Hemodialysis treatment induces markers of inflammation and oxidative stress, which could affect hemoglobin levels and the response to erythropoietin use. This study sought to determine whether high-flux dialysis would help improve markers of renal anemia, inflammation, and oxidative stress compared with low-flux dialysis. DESIGN, SETTINGS, PARTICIPANTS, & MEASUREMENTS: In a prospective, controlled study, 221 patients undergoing maintenance hemodialysis and receiving darbepoetin-alfa treatment (mean age, 66 years; 55% male) from 19 centers were screened in a 20-week run-in period of low-flux hemodialysis with a synthetic dialysis membrane. Thereafter, 166 patients were enrolled and randomly assigned to receive a synthetic high-flux membrane or to continue on low-flux dialysis for 52 weeks. Data on myeloperoxidase, oxidized LDL, high-sensitivity C-reactive protein, and the Malnutrition Inflammation Score were collected at baseline and after 52 weeks; routine laboratory data, such as hemoglobin, ferritin, and albumin, and the use of darbepoetin-alfa, were also measured in the run-in period. Results After 52 weeks, the low-flux and the high-flux groups did not differ with respect to hemoglobin (mean ± SD, 11.7±0.9 g/dl versus 11.7±1.1 g/dl; P=0.62) or use of darbepoetin-alfa (mean dosage ± SD, 29.8±24.8 μg/wk versus 26.0±31.1 μg/wk; P=0.85). Markers of inflammation, oxidative stress, or nutritional status also did not differ between groups. CONCLUSION: Over 1 year, high-flux dialysis had no superior effects on hemoglobin levels or markers of inflammation, oxidative stress, and nutritional status. These data do not support the hypothesis that enhanced convective toxin removal would improve patient outcome.
Authors: F Locatelli; S Andrulli; F Pecchini; L Pedrini; S Agliata; L Lucchi; M Farina; V La Milia; C Grassi; M Borghi; B Redaelli; F Conte; G Ratto; G Cabiddu; C Grossi; R Modenese Journal: Nephrol Dial Transplant Date: 2000-09 Impact factor: 5.992
Authors: Garabed Eknoyan; Gerald J Beck; Alfred K Cheung; John T Daugirdas; Tom Greene; John W Kusek; Michael Allon; James Bailey; James A Delmez; Thomas A Depner; Johanna T Dwyer; Andrew S Levey; Nathan W Levin; Edgar Milford; Daniel B Ornt; Michael V Rocco; Gerald Schulman; Steve J Schwab; Brendan P Teehan; Robert Toto Journal: N Engl J Med Date: 2002-12-19 Impact factor: 91.245
Authors: Morrell Michael Avram; Daniel Blaustein; Paul A Fein; Naveen Goel; Jyotiprakas Chattopadhyay; Neal Mittman Journal: Kidney Int Suppl Date: 2003-11 Impact factor: 10.545
Authors: Kamyar Kalantar-Zadeh; Charles J McAllister; Robert S Lehn; Grace H Lee; Allen R Nissenson; Joel D Kopple Journal: Am J Kidney Dis Date: 2003-10 Impact factor: 8.860
Authors: Andreas Schneider; Markus P Schneider; Detlef H Krieter; Bernd Genser; Hubert Scharnagl; Tatjana Stojakovic; Christoph Wanner; Christiane Drechsler Journal: PLoS One Date: 2015-05-29 Impact factor: 3.240
Authors: Simon W Lines; Angela M Carter; Emma J Dunn; Elizabeth J Lindley; James E Tattersall; Mark J Wright Journal: Nephrol Dial Transplant Date: 2013-11-28 Impact factor: 5.992