标准高通量聚砜膜与新型高通量聚砜膜对炎症标志物的影响:一项随机、单盲、对照临床试验。
The impact of standard high-flux polysulfone versus novel high-flux polysulfone dialysis membranes on inflammatory markers: a randomized, single-blinded, controlled clinical trial.
作者信息
Kerr Peter G, Sutherland Wayne H F, de Jong Sylvia, Vaithalingham Indran, Williams Sheila M, Walker Robert J
机构信息
Department of Nephrology, Monash Medical Centre, Victoria, Australia.
出版信息
Am J Kidney Dis. 2007 Apr;49(4):533-9. doi: 10.1053/j.ajkd.2006.12.019.
BACKGROUND
This study is a prospective, randomized, single-blind, clinical trial over 12 months involving 60 stable hemodialysis patients comparing standard high-flux polysulfone dialyzer membranes with a novel high-flux polysulfone dialyzer membrane (Helixone; Fresenius Medical Care, St Wendel, Germany) modified in the fiber-spinning process to enhance middle-molecule clearance through changing the distribution of pore size and increased filtration.
METHODS
Markers of protein and lipid oxidation and inflammatory markers, including proinflammatory cytokines and cell adhesion molecules, were compared. The hypothesis tested was that improved clearances of middle molecules with the FX80 membrane would lead to less oxidative stress and inflammation compared with the high-flux polysulfone (HF80) membrane.
RESULTS
Type of dialysis membrane used did not significantly affect lipid and protein peroxidation, C-reactive protein level, interleukin 6 level, or sgp130 level during 12 months. beta(2)-Microglobulin concentrations decreased significantly in the Helixone membrane group compared with those dialyzed using conventional polysulfone membranes during the study (-15%; 95% confidence interval, -20 to -10).
CONCLUSION
Long-term dialysis with a Helixone membrane did not modify any parameters of oxidative stress or inflammation in this stable hemodialysis population compared with a high-flux polysulfone dialysis membrane.
背景
本研究是一项为期12个月的前瞻性、随机、单盲临床试验,纳入60例稳定的血液透析患者,比较标准高通量聚砜透析器膜与一种新型高通量聚砜透析器膜(Helixone;德国费森尤斯医疗集团,圣温德尔),该新型膜在纤维纺丝过程中进行了改良,通过改变孔径分布和增加滤过来提高中分子清除率。
方法
比较蛋白质和脂质氧化标志物以及炎症标志物,包括促炎细胞因子和细胞黏附分子。所检验的假设是,与高通量聚砜(HF80)膜相比,FX80膜改善中分子清除率将导致氧化应激和炎症减轻。
结果
在12个月期间,所使用的透析膜类型对脂质和蛋白质过氧化、C反应蛋白水平、白细胞介素6水平或可溶性糖蛋白-130水平均无显著影响。在研究期间,与使用传统聚砜膜透析的患者相比,Helixone膜组的β2微球蛋白浓度显著降低(-15%;95%置信区间,-20至-10)。
结论
与高通量聚砜透析膜相比,在这组稳定的血液透析人群中,使用Helixone膜进行长期透析并未改变氧化应激或炎症的任何参数。