Effect of a More Permeable Dialysis Membrane on ESA Resistance in Hemodialysis Patients - A Pilot Investigation
Background/Aims: Hemodialysis (HD) patients often show impaired response to erythropoiesis-stimulating agents (ESAs). Extended HD membrane permeability may potentially improve ESA response. Methods: Twenty-four prevalent HD patients were randomly assigned to 12 weeks use of high cut-off (HCO) membra...
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| Veröffentlicht in: | Blood purification 2016-01, Vol.41 (1-3), p.80-86 |
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| container_title | Blood purification |
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| creator | Teatini, Ugo Liebchen, Ariane Nilsson, Lars-Göran Beck, Werner Romei Longhena, Giorgio |
| description | Background/Aims: Hemodialysis (HD) patients often show impaired response to erythropoiesis-stimulating agents (ESAs). Extended HD membrane permeability may potentially improve ESA response. Methods: Twenty-four prevalent HD patients were randomly assigned to 12 weeks use of high cut-off (HCO) membrane (in every second dialysis treatment) or continued treatment with high-flux membrane. We monitored changes in hemoglobin (Hb), ESA dose, and key biochemical markers. Results: The Hb level increased in the study group (from 11.6 ± 1.0 to 12.5 ± 1.5 g/dl; p = 0.038) but was stable in the control group. Variation over time in ESA dose and ESA resistance index did not differ between groups. HCO membrane usage for 12 weeks led to decreased hepcidin level, from 303 ± 189 to 157 ± 83 ng/ml (p = 0.024); serum albumin level decreased and stabilized 15 ± 6% below baseline. Conclusions: These results indicate that use of a more permeable dialysis membrane may improve ESA responsiveness in iron-replete HD patients. Extensive albumin removal may preclude long-term use of the HCO membrane. |
| doi_str_mv | 10.1159/000441437 |
| format | Article |
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Extended HD membrane permeability may potentially improve ESA response. Methods: Twenty-four prevalent HD patients were randomly assigned to 12 weeks use of high cut-off (HCO) membrane (in every second dialysis treatment) or continued treatment with high-flux membrane. We monitored changes in hemoglobin (Hb), ESA dose, and key biochemical markers. Results: The Hb level increased in the study group (from 11.6 ± 1.0 to 12.5 ± 1.5 g/dl; p = 0.038) but was stable in the control group. Variation over time in ESA dose and ESA resistance index did not differ between groups. HCO membrane usage for 12 weeks led to decreased hepcidin level, from 303 ± 189 to 157 ± 83 ng/ml (p = 0.024); serum albumin level decreased and stabilized 15 ± 6% below baseline. Conclusions: These results indicate that use of a more permeable dialysis membrane may improve ESA responsiveness in iron-replete HD patients. Extensive albumin removal may preclude long-term use of the HCO membrane.</description><identifier>ISSN: 0253-5068</identifier><identifier>EISSN: 1421-9735</identifier><identifier>DOI: 10.1159/000441437</identifier><identifier>PMID: 26536083</identifier><language>eng</language><publisher>Basel, Switzerland</publisher><subject>Aged ; Anemia - blood ; Anemia - complications ; Anemia - pathology ; Anemia - therapy ; C-Reactive Protein - metabolism ; Drug Resistance ; Epoetin Alfa - therapeutic use ; Erythropoietin - therapeutic use ; Female ; Hematinics - therapeutic use ; Hemoglobins - metabolism ; Hepcidins - blood ; Humans ; Interleukin-6 - blood ; Kidney Failure, Chronic - blood ; Kidney Failure, Chronic - complications ; Kidney Failure, Chronic - pathology ; Kidney Failure, Chronic - therapy ; Male ; Membranes, Artificial ; Middle Aged ; Original Paper ; Permeability ; Pilot Projects ; Recombinant Proteins - therapeutic use ; Renal Dialysis - instrumentation ; Serum Albumin - metabolism</subject><ispartof>Blood purification, 2016-01, Vol.41 (1-3), p.80-86</ispartof><rights>2015 S. Karger AG, Basel</rights><rights>2015 S. Karger AG, Basel.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c306t-8f18e6f50f5b7b4d4fd2630dcec7efd4da05cfc835944ad5016953bbca74728f3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,2429,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26536083$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Teatini, Ugo</creatorcontrib><creatorcontrib>Liebchen, Ariane</creatorcontrib><creatorcontrib>Nilsson, Lars-Göran</creatorcontrib><creatorcontrib>Beck, Werner</creatorcontrib><creatorcontrib>Romei Longhena, Giorgio</creatorcontrib><title>Effect of a More Permeable Dialysis Membrane on ESA Resistance in Hemodialysis Patients - A Pilot Investigation</title><title>Blood purification</title><addtitle>Blood Purif</addtitle><description>Background/Aims: Hemodialysis (HD) patients often show impaired response to erythropoiesis-stimulating agents (ESAs). Extended HD membrane permeability may potentially improve ESA response. Methods: Twenty-four prevalent HD patients were randomly assigned to 12 weeks use of high cut-off (HCO) membrane (in every second dialysis treatment) or continued treatment with high-flux membrane. We monitored changes in hemoglobin (Hb), ESA dose, and key biochemical markers. Results: The Hb level increased in the study group (from 11.6 ± 1.0 to 12.5 ± 1.5 g/dl; p = 0.038) but was stable in the control group. Variation over time in ESA dose and ESA resistance index did not differ between groups. HCO membrane usage for 12 weeks led to decreased hepcidin level, from 303 ± 189 to 157 ± 83 ng/ml (p = 0.024); serum albumin level decreased and stabilized 15 ± 6% below baseline. Conclusions: These results indicate that use of a more permeable dialysis membrane may improve ESA responsiveness in iron-replete HD patients. Extensive albumin removal may preclude long-term use of the HCO membrane.</description><subject>Aged</subject><subject>Anemia - blood</subject><subject>Anemia - complications</subject><subject>Anemia - pathology</subject><subject>Anemia - therapy</subject><subject>C-Reactive Protein - metabolism</subject><subject>Drug Resistance</subject><subject>Epoetin Alfa - therapeutic use</subject><subject>Erythropoietin - therapeutic use</subject><subject>Female</subject><subject>Hematinics - therapeutic use</subject><subject>Hemoglobins - metabolism</subject><subject>Hepcidins - blood</subject><subject>Humans</subject><subject>Interleukin-6 - blood</subject><subject>Kidney Failure, Chronic - blood</subject><subject>Kidney Failure, Chronic - complications</subject><subject>Kidney Failure, Chronic - pathology</subject><subject>Kidney Failure, Chronic - therapy</subject><subject>Male</subject><subject>Membranes, Artificial</subject><subject>Middle Aged</subject><subject>Original Paper</subject><subject>Permeability</subject><subject>Pilot Projects</subject><subject>Recombinant Proteins - therapeutic use</subject><subject>Renal Dialysis - instrumentation</subject><subject>Serum Albumin - metabolism</subject><issn>0253-5068</issn><issn>1421-9735</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo90D1PwzAQBmALgWgpDOwIeYQhYMcfScaqFFqpFRUfc-TY5yqQxGCnSP33GLV0snR-7k73InRJyR2lorgnhHBOOcuO0JDylCZFxsQxGpJUsEQQmQ_QWQgfhFAuRXGKBqkUTJKcDZGbWgu6x85ihZfOA16Bb0FVDeCHWjXbUAe8hLbyqgPsOjx9HeMXiNVedRpw3eEZtM7805Xqa-j6gBM8xqu6cT2edz8Q-nodf1x3jk6sagJc7N8Ren-cvk1myeL5aT4ZLxLNiOyT3NIcpBXEiiqruOHWpJIRo0FnYA03ightdc5EwbkyglBZCFZVWmU8S3PLRuhmN_fLu-9N3F-2ddDQNPEMtwklzSJjBclppLc7qr0LwYMtv3zdKr8tKSn_8i0P-UZ7vR-7qVowB_kfaARXO_Cp_Br8Aez7fwFDOX4O</recordid><startdate>20160101</startdate><enddate>20160101</enddate><creator>Teatini, Ugo</creator><creator>Liebchen, Ariane</creator><creator>Nilsson, Lars-Göran</creator><creator>Beck, Werner</creator><creator>Romei Longhena, Giorgio</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20160101</creationdate><title>Effect of a More Permeable Dialysis Membrane on ESA Resistance in Hemodialysis Patients - A Pilot Investigation</title><author>Teatini, Ugo ; Liebchen, Ariane ; Nilsson, Lars-Göran ; Beck, Werner ; Romei Longhena, Giorgio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c306t-8f18e6f50f5b7b4d4fd2630dcec7efd4da05cfc835944ad5016953bbca74728f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Anemia - blood</topic><topic>Anemia - complications</topic><topic>Anemia - pathology</topic><topic>Anemia - therapy</topic><topic>C-Reactive Protein - metabolism</topic><topic>Drug Resistance</topic><topic>Epoetin Alfa - therapeutic use</topic><topic>Erythropoietin - therapeutic use</topic><topic>Female</topic><topic>Hematinics - therapeutic use</topic><topic>Hemoglobins - metabolism</topic><topic>Hepcidins - blood</topic><topic>Humans</topic><topic>Interleukin-6 - blood</topic><topic>Kidney Failure, Chronic - blood</topic><topic>Kidney Failure, Chronic - complications</topic><topic>Kidney Failure, Chronic - pathology</topic><topic>Kidney Failure, Chronic - therapy</topic><topic>Male</topic><topic>Membranes, Artificial</topic><topic>Middle Aged</topic><topic>Original Paper</topic><topic>Permeability</topic><topic>Pilot Projects</topic><topic>Recombinant Proteins - therapeutic use</topic><topic>Renal Dialysis - instrumentation</topic><topic>Serum Albumin - metabolism</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Teatini, Ugo</creatorcontrib><creatorcontrib>Liebchen, Ariane</creatorcontrib><creatorcontrib>Nilsson, Lars-Göran</creatorcontrib><creatorcontrib>Beck, Werner</creatorcontrib><creatorcontrib>Romei Longhena, Giorgio</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Blood purification</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Teatini, Ugo</au><au>Liebchen, Ariane</au><au>Nilsson, Lars-Göran</au><au>Beck, Werner</au><au>Romei Longhena, Giorgio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of a More Permeable Dialysis Membrane on ESA Resistance in Hemodialysis Patients - A Pilot Investigation</atitle><jtitle>Blood purification</jtitle><addtitle>Blood Purif</addtitle><date>2016-01-01</date><risdate>2016</risdate><volume>41</volume><issue>1-3</issue><spage>80</spage><epage>86</epage><pages>80-86</pages><issn>0253-5068</issn><eissn>1421-9735</eissn><abstract>Background/Aims: Hemodialysis (HD) patients often show impaired response to erythropoiesis-stimulating agents (ESAs). Extended HD membrane permeability may potentially improve ESA response. Methods: Twenty-four prevalent HD patients were randomly assigned to 12 weeks use of high cut-off (HCO) membrane (in every second dialysis treatment) or continued treatment with high-flux membrane. We monitored changes in hemoglobin (Hb), ESA dose, and key biochemical markers. Results: The Hb level increased in the study group (from 11.6 ± 1.0 to 12.5 ± 1.5 g/dl; p = 0.038) but was stable in the control group. Variation over time in ESA dose and ESA resistance index did not differ between groups. HCO membrane usage for 12 weeks led to decreased hepcidin level, from 303 ± 189 to 157 ± 83 ng/ml (p = 0.024); serum albumin level decreased and stabilized 15 ± 6% below baseline. Conclusions: These results indicate that use of a more permeable dialysis membrane may improve ESA responsiveness in iron-replete HD patients. Extensive albumin removal may preclude long-term use of the HCO membrane.</abstract><cop>Basel, Switzerland</cop><pmid>26536083</pmid><doi>10.1159/000441437</doi><tpages>7</tpages></addata></record> |
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| source | MEDLINE; Karger Journals |
| subjects | Aged Anemia - blood Anemia - complications Anemia - pathology Anemia - therapy C-Reactive Protein - metabolism Drug Resistance Epoetin Alfa - therapeutic use Erythropoietin - therapeutic use Female Hematinics - therapeutic use Hemoglobins - metabolism Hepcidins - blood Humans Interleukin-6 - blood Kidney Failure, Chronic - blood Kidney Failure, Chronic - complications Kidney Failure, Chronic - pathology Kidney Failure, Chronic - therapy Male Membranes, Artificial Middle Aged Original Paper Permeability Pilot Projects Recombinant Proteins - therapeutic use Renal Dialysis - instrumentation Serum Albumin - metabolism |
| title | Effect of a More Permeable Dialysis Membrane on ESA Resistance in Hemodialysis Patients - A Pilot Investigation |
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