Long-term use of vitamin E-coated polysulfone membrane reduces oxidative stress markers in haemodialysis patients.
BACKGROUND
Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide synthase and an independent predictor of overall mortality and cardiovascular outcome in haemodialysis (HD) patients. In the present study, we compared the effects of a vitamin E-coated polysulfone membrane (PSE) and a non-vitamin E-coated polysulfone membrane (PS) on oxidative stress markers such as ADMA.


METHODS
Thirty-one HD patients were enrolled to this investigation. They were allocated into two groups: in the PSE group (n = 16), PSE was used for 6 months, followed by PS for an additional 12 months; in the PS group (n = 15), PS was used for the entire observation period. Plasma ADMA, oxidized low density lipoprotein (Ox-LDL) and malondialdehyde LDL (MDA-LDL) levels were measured at baseline, 3, 6, 12 and 18 months. Plasma ADMA in peritoneal dialysis (PD) patients and in healthy individuals was also measured.


RESULTS
Predialysis concentrations of ADMA (0.72+/- 0.13 nmol/ml) were significantly higher in the HD group than in both PD patients (0.63+/-0.10 nmol/ml, P<0.01) and healthy individuals (0.44+/-0.01 nmol/ml, P<0.0001). Treatment with PSE for 6 months significantly reduced predialysis levels of ADMA (0.54+/-0.09 nmol/ml) compared with baseline (0.74+/-0.12 nmol/ml; P<0.01). Predialysis levels of Ox-LDL and MDA-LDL after 6 months therapy with PSE were also significantly lower than baseline values. Treatment with PS subsequent to treatment with PSE again increased ADMA, Ox-LDL and MDA-LDL back to baseline levels. In the PS group, ADMA, Ox-LDL and MDA-LDL levels remained unchanged during the entire treatment period of 18 months.


CONCLUSIONS
We confirmed that use of PSE reduced ADMA that had accumulated in HD patients. This finding indicates that PSE exerts anti-oxidant activity. A randomized controlled study will be required to determine whether PSE prevents cardiovascular diseases and other dialysis-related complications by reducing oxidative stress.
Morimoto
Hisanori
H
Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Okayama 700-8558, Japan.
Nakao
Kazushi
K
Fukuoka
Kousuke
K
Sarai
Ai
A
Yano
Ai
A
Kihara
Takashi
T
Fukuda
Shinji
S
Wada
Jun
J
Makino
Hirofumi
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000975:Antioxidants / Q000627:therapeutic use*; D001120:Arginine / Q000031:analogs & derivatives / Q000097:blood; D015415:Biomarkers / Q000097:blood; D020099:Coated Materials, Biocompatible / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D019001:Nitric Oxide Synthase / Q000037:antagonists & inhibitors; D018384:Oxidative Stress / Q000187:drug effects*; D011108:Polymers; D011379:Prognosis; D006435:Renal Dialysis / Q000295:instrumentation*; D013450:Sulfones; D013997:Time Factors; D014810:Vitamin E / Q000627:therapeutic use*
D000975:Antioxidants; D015415:Biomarkers; D020099:Coated Materials, Biocompatible; D008077:Lipoproteins, LDL; D008567:Membranes, Artificial; D011108:Polymers; D013450:Sulfones; C099252:oxidized low density lipoprotein; D014810:Vitamin E; C017662:polysulfone P 1700; C018524:N,N-dimethylarginine; D001120:Arginine; D019001:Nitric Oxide Synthase