Markers of endothelial damage in patients on hemodialysis and hemodiafiltration

The purpose of the study was to assess whether renal replacement therapy (RRT) in the form of hemodialysis (HD) or hemodiafiltration (HDF) affects hemostasis and endothelial function in patients with end-stage renal failure (ESRF). Thirty-five hemodialyzed patients and 14 HDF patients were evaluated regarding hemostatic parameters, serum lipids and endothelial cell injury markers. HD patients did not differ significantly in regard to serum lipids, complete blood count, hemostasis, and dialysis adequacy as measured by Kt/V when compared to HDF patients. Only the markers of endothelial cell injury thrombomodulin and von Willebrand factor were significantly higher in HD when compared to HDF. Patients on HD showed evidence of a higher degree of endothelial dysfunction than HDF patients. HDF seems to ameliorate endothelial dysfunction in comparison with HD. Therefore, hemostatic abnormalities in ESRF might be affected to some extent by the choice of RRT.