NDT Advance Access originally published online on July 27, 2004
Nephrology Dialysis Transplantation 2004 19(10):2570-2575; doi:10.1093/ndt/gfh415
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Nephrol Dial Transplant Vol. 19 No. 10 © ERA-EDTA 2004; all rights reserved
Original Article
Effect of dialysis flux and membrane material on dyslipidaemia and inflammation in haemodialysis patients
1 Department of Medicine, Division of Nephrology, University Clinic of Würzburg, Würzburg, 2 Kuratorium für Dialyse und Nierentransplantation, Würzburg and 3 Fresenius Medical Care, Bad Homburg, Germany
Correspondence and offprint requests to: Christoph Wanner, MD, Department of Medicine, Division of Nephrology, University Hospital, Josef-Schneider-Strasse 2, D-97080 Wuerzburg, Germany. Email: wanner_c{at}klinik.uni-wuerzburg.de
Background. Dyslipidaemia, inflammation and oxidative stress are prominent risk factors that potentially cause vascular disease in haemodialysis patients. Dialysis modalities affect uraemic dyslipidaemia, possibly by modifying oxidative stress, but the effects of dialyser flux and membrane material on atherogenic remnant particles and oxidized low-density lipoproteins (LDL) are unknown.
Methods. We performed a randomized crossover study in 36 patients on haemodialysis to analyse the effect of dialyser flux and membrane material on plasma lipids, apolipoproteins and markers of inflammation and oxidative stress. Stable patients on low-flux dialysis with polysulphone for 
6 weeks were assigned to high-flux polysulphone or high-flux modified cellulose with similar dialyser surface area and permeability characteristics and crossed over twice every 6 weeks.
Results. Thirty patients completed the study per protocol. Treatments with high-flux polysulphone and modified cellulose lowered serum triglyceride (by 20% and 10%, respectively; P<0.05) and remnant-like particle cholesterol by 32% (P<0.001) and 11% (NS) after the first 6 weeks of treatment. Oxidized LDL decreased significantly with high-flux polysulphone, but not with modified cellulose. Apolipoproteins CII and CIII were reduced, whereas the ratio CII/CIII was increased (all P<0.05). Acute-phase proteins and LDL and high-density lipoprotein cholesterol remained unaffected.
Conclusions. This randomized crossover study demonstrates a potent effect of high-flux haemodialysis on uraemic dyslipidaemia. Polysulphone membrane material showed superiority on oxidatively modified LDL, an indicator of oxidative stress in haemodialysis patients.
Keywords: acute-phase proteins; apolipoproteins; high-flux haemodialysis; lipids; oxidative stress; polysulphone
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