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Open Access 01-12-2016 | Research article

Vitamins (A, C and E) and oxidative status of hemodialysis patients treated with HFR and HFR-Supra

Authors: Simonetta Palleschi, Paolo M. Ghezzi, Giuseppe Palladino, Barbara Rossi, Marino Ganadu, Domenica Casu, Maria Cossu, Giovanni Mattana, Antonio Maria Pinna, Bruno Contu, Tonina Ghisu, Alessandro Monni, Luana Gazzanelli, Maria Cristina Mereu, Franco Logias, Mario Passaghe, Alessandro Amore, Piergiorgio Bolasco, on behalf of the Sardinian Study Group

Published in: BMC Nephrology | Issue 1/2016

Abstract

Background

Hemodiafiltration with on-line endogenous reinfusion (HFR) is an extracorporeal dialytic method that combines diffusion, convection and adsorption. HFR-Supra (HFR-S) is a second-generation system with increased convective permeability and adsorption capability. Previous studies suggested that HFR reduces oxidative stress compared to standard haemodialysis. The principal aim of the present study was to compare antioxidant vitamins behavior and oxidative status of hemodialysis patients treated with HFR and HFR-S.

Methods

The study was designed as a multicenter, randomized, crossover trial. Forty-one patients were recruited from 19 dialysis centers and after a 4-month washout stabilization period in on-line hemodiafiltration (ol-HDF), each patient was randomized to a sequence of treatments (HFR-S followed by HFR or viceversa) with each treatment applied over 6 months. Plasma levels of Advanced Oxidation Protein Products, Total Antioxidant Status, vitamins C, A and E and their ligands (Retinol Binding Protein and total lipids) were measured at baseline and at the end of each treatment period.

Results

Results show that the higher convective permeability of HFR-S with respect to HFR did not produce additional beneficial effects on the patients’ oxidative status, a slight decrease of both Vitamin A and Retinol Binding Protein being the only difference registered in the long-term. However, as compared to ol-HDF, both the re-infusive techniques allowed to reduce the intradialytic loss of Vitamin C and, in the long-term, improve the patients’ oxidative status and increase Retinol Binding Protein plasma values. No significant differences were found between the Vitamin C concentration of pre- and post cartridge UF neither in HFR-S nor in HFR showing that the sorbent resin does not adsorb Vitamin C.

Conclusion

HFR-S and HFR are almost equivalent in term of impact on antioxidant vitamins and oxidative status of hemodialysis patients. Nonetheless, as compared to ol-HDF, both treatments produced a sensible sparing of Vitamin C and may represent a new approach for reducing oxidative stress and related complications in dialysis patients. Long-term effects of re-infusive treatments on patients’ cardiovascular morbidity and mortality need to be evaluated.

Trial registration

ClinicalTrials.gov Identifier NCT01492491, retrospectively registered in 10 December 2011.

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Title: Vitamins (A, C and E) and oxidative status of hemodialysis patients treated with HFR and HFR-Supra
Authors: Simonetta Palleschi
Paolo M. Ghezzi
Giuseppe Palladino
Barbara Rossi
Marino Ganadu
Domenica Casu
Maria Cossu
Giovanni Mattana
Antonio Maria Pinna
Bruno Contu
Tonina Ghisu
Alessandro Monni
Luana Gazzanelli
Maria Cristina Mereu
Franco Logias
Mario Passaghe
Alessandro Amore
Piergiorgio Bolasco
on behalf of the Sardinian Study Group
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: BMC Nephrology / Issue 1/2016
Electronic ISSN: 1471-2369
DOI: https://doi.org/10.1186/s12882-016-0315-6

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Vitamins (A, C and E) and oxidative status of hemodialysis patients treated with HFR and HFR-Supra

Abstract

Background

Methods

Results

Conclusion

Trial registration

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Abstract

Background

Methods

Results

Conclusion

Trial registration

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