title: Relation of middle molecules levels and oxidative stress to erythropoietin requirements in high-flux versus low-flux hemodialysis.
abstract: The objective of this study is to investigate the serum beta-2-microglobulin (B2MG) and advanced oxidation protein products (AOPP) as middle molecule uremic toxins and protein carbonyl (PCO) as oxidative stress marker in uremic patients undergoing high-flux versus low-flux hemodialysis (HD) and to correlate their levels to the erythropoietin requirements for those patients. Twenty patients on chronic low-flux HD were recruited in the study. At the start of the study, all patients underwent high-flux HD for eight weeks, followed by low-flux HD for two weeks as a washout period. The patients were then subjected to another eight weeks of low-flux HD. Blood samples were obtained at the beginning and at the end of the high-flux period and the low-flux period. The mean erythropoietin dose for patients using high-flux HD was significantly lower than that for low-flux HD (P = 0.0062). Post-high flux, the B2MG and PCO levels were significantly lower than the pre-high-flux levels (P = 0.026 and 0.0005, respectively), but no significant change was observed in AOPP (P = 0.68). Post-low flux, the B2MG, AOPP and PCO were significantly higher than the pre-low-flux levels (P = 0.0002, 0.021 and <0.0001, respectively). Post-low flux, the B2MG and PCO were significantly higher than the post-high-flux levels (P <0.0001), but no significant difference was observed in AOPP (P = 0.11). High-flux HD results in reduction of some of the middle molecule toxins and PCO levels better than low-flux HD, and is associated with a better response to erythropoietin.
authors.affiliation: Department of Nephrology, Faculty of Medicine, Alexandria University, Alexandria, Egypt. halaelwaki@hotmail.com
authors.forename: Hala S
authors.initials: HS
authors.lastname: El-Wakil
authors.forename: Abla A
authors.initials: AA
authors.lastname: Abou-Zeid
authors.forename: Iman E
authors.initials: IE
authors.lastname: El-Gohary
authors.forename: Nahla A
authors.initials: NA
authors.lastname: Abou El-Seoud
mesh_terms: D062107:Advanced Oxidation Protein Products / Q000097:blood*; D018592:Cross-Over Studies; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008567:Membranes, Artificial; D018384:Oxidative Stress; D050050:Protein Carbonylation / Q000502:physiology; D006435:Renal Dialysis / Q000379:methods*; D014118:Toxins, Biological / Q000097:blood*; D014511:Uremia / Q000097:blood / Q000628:therapy*; D001613:beta 2-Microglobulin / Q000097:blood*
chemical_list: D062107:Advanced Oxidation Protein Products; D008567:Membranes, Artificial; D014118:Toxins, Biological; D001613:beta 2-Microglobulin; C026865:uremia middle molecule toxins; D004921:Erythropoietin