Comparison of the effects of polysulfone and polyester-polymer alloy dialyzers on glycemic control in diabetic patients undergoing hemodialysis.
BACKGROUND
Though different high-flux dialyzers are available, there are no comparative studies on their glycemic control effects on diabetic hemodialysis (HD) patients. In this crossover study, we compared the effects of polysulfone (PS) and polyester-polymer alloy (PEPA) dialyzers.


METHODS
We recruited 47 diabetic HD patients. The conventional dialyzers were replaced with PS or PEPA dialyzers and the patients were treated for 16 weeks. Subsequently, after interchanging the PS and PEPA dialyzers, the treatment continued for another 16 weeks. For each dialyzer, we analyzed the glycemic control effect and measured their clearance and reduction rates of insulin.


RESULTS
The PEPA dialyzer lowered the glycated albumin (GA) levels more significantly than the PS dialyzer. While the groups exhibited no differences in metabolic parameters, the clearance and reduction rates of insulin were more significant in the PS. A significant decrease was observed in the levels of GA, fasting plasma glucose, and glycated hemoglobin in patients with lower fasting C-peptide levels (< 6.0 ng/ml).


CONCLUSIONS
Glycemic control in diabetic HD patients is affected by the type of dialyzer used. Our results indicate that the PEPA dialyzer is more potent in controlling glycemia than the PS dialyzer in diabetic HD patients.
Abe
M
M
Division of Nephrology, Hypertension and Endocrinology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan. mabe@med.nihon-u.ac.jp
Okada
K
K
Maruyama
T
T
Ikeda
K
K
Kikuchi
F
F
Kaizu
K
K
Matsumoto
K
K
D000497:Alloys; D001672:Biocompatible Materials; D001786:Blood Glucose / Q000032:analysis*; D018592:Cross-Over Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D011091:Polyesters; D011108:Polymers; D011446:Prospective Studies; D011863:Radioimmunoassay; D006435:Renal Dialysis / Q000295:instrumentation*; D013450:Sulfones; D016896:Treatment Outcome
D000497:Alloys; D001672:Biocompatible Materials; D001786:Blood Glucose; D008567:Membranes, Artificial; D011091:Polyesters; D011108:Polymers; D013450:Sulfones; C017662:polysulfone P 1700