title: Improvement of intradialytic hypotension in diabetic hemodialysis patients using vitamin E-bonded polysulfone membrane dialyzers.
abstract: Currently, there are no detailed reports on the effects of vitamin E-bonded polysulfone (PS) membrane dialyzers on intradialytic hypotension (IDH) in diabetic hemodialysis (HD) patients. This study was designed to evaluate changes in intradialytic systolic blood pressure (SBP) using "VPS-HA" vitamin E-bonded super high-flux PS membrane dialyzers. The subjects were 62 diabetic HD patients whose intradialytic SBP fell by more than 20%. Group A comprised patients who required vasopressors to be able to continue treatment or who had to discontinue therapy due to their lowest intradialytic SBP being observed at 210 min (28 patients). Group B comprised patients who showed no symptoms and required no vasopressors but showed a gradual reduction in blood pressure, with the lowest intradialytic SBP seen at the end of dialysis (34 patients). The primary outcome was defined as the lowest intradialytic SBP after 3 months using VPS-HA. Secondary outcomes included changes in the following: lowest intradialytic diastolic blood pressure, pulse pressure, pulse rate, plasma nitric oxide and peroxynitrite, serum albumin, and hemoglobin A1c. Group A's lowest intradialytic SBP had significantly improved at 3 months (128.0 ±  25.1 mm Hg vs. 117.1 ± 29.2 mm Hg; P = 0.017). Group B's lowest intradialytic SBP had significantly improved at 1 month (134.4 ± 13.2 mm Hg vs. 121.5 ± 25.8 mm Hg; P =  0.047) and 3 months (139.1 ± 20.9 mm Hg vs. 121.5 ±  25.8 mm Hg; P = 0.011). We conclude that VPS-HA may improve IDH in diabetic HD patients.
authors: Asahi Kasei Kuraray Medical Hoshi University Asahi Kasei Pharma, Tokyo, Japan.
authors: Masahide
authors: M
authors: Koremoto
authors: Noriko
authors: N
authors: Takahara
authors: Masahiro
authors: M
authors: Takahashi
authors: Yasuhiro
authors: Y
authors: Okada
authors: Kouhei
authors: K
authors: Satoh
authors: Tomoyoshi
authors: T
authors: Kimura
authors: Tomoyuki
authors: T
authors: Hirai
authors: Itaru
authors: I
authors: Ebihara
authors: Daisuke
authors: D
authors: Nagasaku
authors: Shigeo
authors: S
authors: Miyata
authors: Shunji
authors: S
authors: Maniwa
authors: Takuji
authors: T
authors: Kouzuma
authors: Tetsurou
authors: T
authors: Arimura
authors: Junzou
authors: J
authors: Kamei
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000187:drug effects*; D003928:Diabetic Nephropathies / Q000097:blood / Q000150:complications / Q000628:therapy*; D005260:Female; D006801:Humans; D007022:Hypotension / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000097:blood; D030421:Peroxynitrous Acid / Q000097:blood; D011108:Polymers / Q000737:chemistry; D006435:Renal Dialysis / Q000379:methods*; D012709:Serum Albumin / Q000032:analysis; D013450:Sulfones / Q000737:chemistry; D014662:Vasoconstrictor Agents / Q000627:therapeutic use; D014810:Vitamin E / Q000737:chemistry / Q000627:therapeutic use*
chemical_list: D011108:Polymers; D012709:Serum Albumin; D013450:Sulfones; D014662:Vasoconstrictor Agents; D014810:Vitamin E; D030421:Peroxynitrous Acid; C017662:polysulfone P 1700; D009569:Nitric Oxide