title: The effects of vitamin E-coated membrane dialyzer compared to simvastatin in patients on chronic hemodialysis.
abstract: BACKGROUND
  We investigated the effects of the use of vitamin E-coated membrane (VEM) dialyzer in comparison to simvastatin on markers of chronic inflammation, oxidative stress, and endothelial cell apoptosis in ten patients on chronic hemodialysis (HD), aiming at distinguishing the different treatment effects and their time sequence on these pathogenetic routes.
  
  
  METHODS
  Ten HD patients were sequentially submitted to a 6-month treatment with the use of VEM and 10 mg of simvastatin daily, interrupted by a 3-month washout period. At baseline, at 3, and 6 months of each trial, serum C-reactive protein (CRP), apolipoprotein (Apo) A1 and B, lipoprotein-a [Lp(a)], high-sensitivity interleukin-6 (hsIL-6), monocyte chemoattractant protein-1 (MCP-1), soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble E-selectin (sE-selectin), soluble Fas (sFas), soluble Fas ligand (sFasL), and plasma oxidized low-density lipoproteins (oxLDL) levels were determined.
  
  
  RESULTS
  VEM treatment resulted in a significant decrease in CRP, IL-6, sICAM-1 at 3 months, and oxLDL at 6 months, compared to baseline. Simvastatin resulted in a significant decrease in CRP, which correlated with decreases in both total (r = 0.87, p < 0.05) and low-density lipoprotein cholesterol, IL-6, sICAM-1, sVCAM-1, oxLDL, and sFas at 6 months, compared to baseline. Simvastatin effects on sVCAM-1 (mean difference = 652 ng/mL; 95% CI = 294 to 2686; p < 0.05) and sFas (mean difference = 1284 pg/mL; 95% CI = 510 to 1910; p < 0.05) differed significantly from the corresponding VEM effects.
  
  
  CONCLUSIONS
  The 6-month use of VEM resulted in more direct and immediate anti-inflammatory effects compared with those caused by the 6-month treatment with simvastatin. Simvastatin caused a more intense decrease in the markers of inflammation, which was in part correlated with its lipid-lowering effects.
authors.affiliation: Department of Nephrology, Hippokration General Hospital, Aristotle University, Thessaloniki, Greece. dkirmizis@yahoo.co.uk
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Kirmizis
authors.forename: Aikaterini
authors.initials: A
authors.lastname: Papagianni
authors.forename: Fani
authors.initials: F
authors.lastname: Dogrammatzi
authors.forename: Anna-Maria
authors.initials: AM
authors.lastname: Belechri
authors.forename: Efstathios
authors.initials: E
authors.lastname: Alexopoulos
authors.forename: Georgios
authors.initials: G
authors.lastname: Efstratiadis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Memmos
mesh_terms: D000178:Acrylamides / Q000097:blood; D000368:Aged; D000975:Antioxidants / Q000494:pharmacology; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000187:drug effects / Q000378:metabolism; D020099:Coated Materials, Biocompatible; D018592:Cross-Over Studies; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology; D007249:Inflammation / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D015850:Interleukin-6 / Q000097:blood; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000628:therapy*; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects; D006435:Renal Dialysis / Q000295:instrumentation*; D019821:Simvastatin / Q000494:pharmacology*; D016896:Treatment Outcome; D014810:Vitamin E / Q000494:pharmacology*; D015091:beta-Alanine / Q000031:analogs & derivatives / Q000097:blood / Q000187:drug effects
chemical_list: C531963:2-(2,6-dichloro-4-((3-furan-2-ylacryloylamino)methyl)benzoylamino)-3-((thiazolidine-4-carbonyl)amino)propionic acid; D000178:Acrylamides; D000975:Antioxidants; D015415:Biomarkers; D020099:Coated Materials, Biocompatible; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D015850:Interleukin-6; D008567:Membranes, Artificial; D015091:beta-Alanine; D014810:Vitamin E; D002097:C-Reactive Protein; D019821:Simvastatin