title: A crossover study of the acrylonitrile-co-methallyl sulfonate and polysulfone membranes for elderly hemodialysis patients: the effect on hemodynamic, nutritional, and inflammatory conditions.
abstract: Many maintenance hemodialysis (MHD) patients have recently been treated with high flux (HF) dialysis membranes such as polysulfone (PSu) membranes. However, the appropriateness of HF for elderly MHD remains to be elucidated. In order to estimate hemodialysis (HD) efficiency, the hemodynamic condition during HD, and the nutritional status, 28 elderly MHD patients were treated with PSu for 3 months. After this, the patients were switched to acrylonitrile-co-methallyl sulfonate (AN69) membranes for the next 3 months and then returned to PSu for another 3 months. Reduction ratio of inflammatory cytokines (interleukin [IL]-6) by AN69 was significantly higher than the reduction ratio by PSu. After 3 months with AN69, the serum total protein, albumin, and cholesterol levels significantly increased, and after switching back to PSu, the levels returned to baseline. Furthermore, the frequency of saline used to treat episodes of hypotension during HD significantly decreased in the AN69 period. In elderly MHD patients, it was possible to achieve improvements in both malnutrition and chronic inflammatory conditions with AN69. This suggests that AN69 may be the preferred membrane for elderly MHD, because it stabilizes the hemodynamic condition and demonstrates a higher removal of inflammatory cytokines during HD.
authors.affiliation: Division of Kidney and Dialysis, Department of Internal Medicine, Hyogo College of Medicine, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Furuta
authors.forename: Takahiro
authors.initials: T
authors.lastname: Kuragano
authors.forename: Aritoshi
authors.initials: A
authors.lastname: Kida
authors.forename: Rie
authors.initials: R
authors.lastname: Kitamura
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Nanami
authors.forename: Yoshinaga
authors.initials: Y
authors.lastname: Otaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nonoguchi
authors.forename: Akihide
authors.initials: A
authors.lastname: Matsumoto
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakanishi
mesh_terms: D000180:Acrylic Resins / Q000737:chemistry*; D000181:Acrylonitrile / Q000031:analogs & derivatives* / Q000737:chemistry*; D000368:Aged; D000476:Alkanesulfonates / Q000737:chemistry*; D002319:Cardiovascular System; D018592:Cross-Over Studies; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007249:Inflammation; D015850:Interleukin-6 / Q000378:metabolism; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D052756:Nutritional Sciences; D011108:Polymers / Q000737:chemistry*; D006435:Renal Dialysis; D013450:Sulfones / Q000737:chemistry*
chemical_list: D000180:Acrylic Resins; D000476:Alkanesulfonates; D015850:Interleukin-6; D008567:Membranes, Artificial; D011108:Polymers; D013450:Sulfones; C017662:polysulfone P 1700; C016892:AN-69; C056081:methallyl sulfonate; D000181:Acrylonitrile