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PMID
24293660
TITLE
A randomized controlled trial evaluating the erythropoiesis stimulating agent sparing potential of a vitamin E-bonded polysulfone dialysis membrane.
ABSTRACT
BACKGROUND NlmCategory: BACKGROUND
Vitamin E (VE) bonded polysulfone dialysis membranes have putative erythropoiesis stimulating agent (ESA)-sparing and anti-inflammatory properties based on data from a small number of studies. We sought to investigate this in a large, prospective 12-month randomized controlled trial.
METHODS NlmCategory: METHODS
Two-hundred and sixty prevalent haemodialysis (HD) patients were randomized to dialysis with VE-bonded polysulfone membranes or non-VE-bonded equivalents. All ESA-dosing was performed by means of a computer-based anaemia management decision support system. Monthly data were used to calculate the ESA resistance index (ERI) and blood tests were performed at baseline, 6 and 12 months for measurement of C-reactive protein (CRP) levels.
RESULTS NlmCategory: RESULTS
Of the 260 patients, 123 were randomized to dialysis with the VE-membrane and 12-month data was available for 220 patients. At the study population level, no beneficial effect of the VE membranes on the ERI or CRP levels was observed. Post hoc analyses indicated that there was a significant fall in ERI for patients with the highest baseline ESA resistance dialysed with the VE (9.28 [7.70-12.5] versus 7.70 [5.34-12.7] IU/week/kg/g/dL Hb, P = 0.01) but not the control membranes (9.45 [7.62-12.3] versus 8.14 [4.44-15.6] IU/week/kg/g/dL Hb, P = 0.41); this was not attributable to changes in CRP levels.
CONCLUSIONS NlmCategory: CONCLUSIONS
Wholesale switching of all chronic HD patients to dialysis with VE-bonded polysulfone membranes appears not to be associated with improvements in ESA-responsiveness or CRP. These membranes may have utility in patients with heightened ESA resistance.
DATE PUBLISHED
2014 Mar
HISTORY
PUBSTATUS PUBSTATUSDATE
aheadofprint 2013/11/28
entrez 2013/12/03 06:00
pubmed 2013/12/03 06:00
medline 2013/12/03 06:00
AUTHORS
NAME COLLECTIVENAME LASTNAME FORENAME INITIALS AFFILIATION AFFILIATIONINFO
Lines SW Lines Simon W SW Department of Nephrology, St. James's University Hospital, Leeds, UK.
Carter AM Carter Angela M AM
Dunn EJ Dunn Emma J EJ
Lindley EJ Lindley Elizabeth J EJ
Tattersall JE Tattersall James E JE
Wright MJ Wright Mark J MJ
INVESTIGATORS
JOURNAL
VOLUME: 29
ISSUE: 3
TITLE: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
ISOABBREVIATION: Nephrol. Dial. Transplant.
YEAR: 2014
MONTH: Mar
DAY:
MEDLINEDATE:
SEASON:
CITEDMEDIUM: Internet
ISSN: 1460-2385
ISSNTYPE: Electronic
MEDLINE JOURNAL
MEDLINETA: Nephrol Dial Transplant
COUNTRY: England
ISSNLINKING: 0931-0509
NLMUNIQUEID: 8706402
PUBLICATION TYPE
PUBLICATIONTYPE TEXT
Journal Article
Research Support, Non-U.S. Gov't
COMMENTS AND CORRECTIONS
REFTYPE REFSOURCE REFPMID NOTE
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GRANTS
GENERAL NOTE
KEYWORDS
KEYWORD
anaemia
haemodialysis
inflammation
vitamin E
MESH HEADINGS
SUPPLEMENTARY MESH
GENE SYMBOLS
CHEMICALS
OTHER ID's
OTHERID SOURCE
PMC3938299 NLM
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