Effects of a medium cut-off dialyzer on inflammation and cardiac and vascular function in hemodialysis patients with heart failure

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY Hemodialysis International Pub Date : 2024-06-25 DOI:10.1111/hdi.13166

Irem Ozarli, Hacı Hasan Yeter, Yusuf Ziya Sener, Cebrail Cebrailov, Tolga Yildirim, Rahmi Yilmaz

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Abstract

Introduction

Expanded hemodialysis (HDx) could provide clearance of larger middle-molecule uremic toxins. We compared the effect of hemodialysis with medium cut-off membranes and high-flux (HFHD) membranes regarding changes in inflammation and vascular and left ventricular function.

Methods

This was a single-center, prospective, parallel-group comparative study. Patients were divided into two groups (HDx: 25 patients and HFHD: 26 patients). All measurements were performed at baseline and 12 weeks. Serum c-reactive protein, interkelukin-18, pentraxin-3, β-2 microglobulin, and brain natriuretic peptide were measured. We used pulse wave velocity and augmentation index to assess arterial stiffness and echocardiography to evaluate left and right ventricular function.

Findings

We enrolled 51 patients. Although serum c-reactive protein, interkelukin-18, pentraxin 3, and β-2 microglobulin were significantly decreased in the HDx group (p = 0.02, p < 0.001, p = 0.002, and p = 0.02, respectively), there was no significant change in HFHD group at 12th week. Serum c-reactive protein and interkelukin-18were significantly lower in the HDx group compared to the HFHD group in the 12th week (p = 0.007 and p = 0.03, respectively). We observed a significant decrease in pulse wave velocity in the HDx group at the end of the study (p = 0.03). Although there was no significant change in pulse wave velocity in the HFHD group, pulse wave velocity was similar between the HDx and HFHD groups in the 12th week. We detected a significant decrease in the mean isovolumetric relaxation time in the HDx group (p = 0.006). However, there was no significant difference in isovolumetric relaxation time between the HDx and HFHD groups in the 12th week.

Discussion

HDx provides better clearance of middle molecular uremic toxins and inflammatory biomarkers, and it may be associated with better central hemodynamic parameters and diastolic functions.

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中截流透析器对心力衰竭血液透析患者的炎症、心脏和血管功能的影响。

简介：扩大血液透析（HDx）可清除较大的中等分子尿毒症毒素。我们比较了使用中截流膜和高通量（HFHD）膜进行血液透析对炎症、血管和左心室功能变化的影响：这是一项单中心、前瞻性、平行组比较研究。患者分为两组（HDx：25 名患者；HFHD：26 名患者）。所有测量均在基线和 12 周时进行。我们测量了血清 c 反应蛋白、白介素-18、五肽-3、β-2 微球蛋白和脑钠肽。我们用脉搏波速度和增强指数来评估动脉僵化，用超声心动图来评估左心室和右心室的功能：我们共招募了 51 名患者。虽然 HDx 组的血清 c 反应蛋白、白介素-18、五肽 3 和 β-2 微球蛋白显著下降（p = 0.02，p 讨论），但 HDx 组的血清 c 反应蛋白、白介素-18、五肽 3 和 β-2 微球蛋白显著下降（p = 0.02，p 讨论）：HDx 能更好地清除中分子尿毒症毒素和炎症生物标志物，而且可能与更好的中心血流动力学参数和舒张功能有关。

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来源期刊

Hemodialysis International UROLOGY & NEPHROLOGY-

CiteScore

2.50

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Hemodialysis International was originally an annual publication containing the Proceedings of the International Symposium on Hemodialysis held in conjunction with the Annual Dialysis Conference. Since 2003, Hemodialysis International is published quarterly and contains original papers on clinical and experimental topics related to dialysis in addition to the Annual Dialysis Conference supplement. This journal is a must-have for nephrologists, nurses, and technicians worldwide. Quarterly issues of Hemodialysis International are included with your membership to the International Society for Hemodialysis. The journal contains original articles, review articles, and commentary to keep readers completely updated in the field of hemodialysis. Edited by international and multidisciplinary experts, Hemodialysis International disseminates critical information in the field.