Nephrology Dialysis Transplantation, Vol 13, Issue 6 1452-1457, Copyright © 1998 by Oxford University Press
A Ingram, A Parbtani and D Churchill
Background: Studies have shown a beneficial effect of
high-flux dialysis on lipids, lipoproteins and lipoprotein lipase (Lpl)
activity. This has been attributed to improved clearance of Lpl-inhibitory
molecules of middle molecular weight, but differences in flux or
biocompatibility have not been addressed. We conducted a blinded cross-over
trial of two cellulose acetate dialysers (AN140, Althin medical Inc. and
CA210, Baxter Inc.) of similar flux (11 ml/h/mmHg transmembrane pressure)
but with different clearances of larger molecules [AN140 sieving
coefficient at mol. wt 11 000 Da ({beta}2-microglobulin) 0.6; CA210
sieving coefficient negligible]. Methods: Sixteen
patients were divided into two groups to receive dialysis with AN140 for 1
week followed by CA210 or vice versa. Before and after
the third dialysis with each membrane, plasma lipid and lipoprotein
concentrations were measured. Post-dialysis post-heparin lipase activity
was measured in six patients. Results: Fifteen
patients completed the study. No difference between dialysers was found for
apolipoprotein (apo) A1, B or total cholesterol measurements. The rise in
triglyceride post-dialysis was attenuated by AN140 (rise
0.05±0.4 mmol/l vs CA210
0.44±0.54 mmol/l, P=0.03), while high density lipoprotein (HDL)
cholesterol was increased by AN140 (rise 0.18±0.12 mmol/l
vs CA210 0.06±0.14 mmol/l, P<0.02).
ApoE rose with AN140 during dialysis but declined with CA210
(1.10±1.06 mg/dl and -0.77±0.63 mg/dl, P=0.002) as
did apoCIII (HDL) (AN140 rise 1.33±2.06 mg/dl; CA210 fall
-0.67±0.73 mg/dl, P=0.001). Lpl activity, measured in six
patients, tended to be higher for AN140 (45.3±10.5 mmol FFA/ml
plasma/h vs CA 210 (37.2±7.9 mmol FFA/ml
plasma/h) (P=0.16). Conclusions: We conclude that
low-flux dialysis using a cellulose acetate membrane with good clearance of
higher molecular weight molecules may be associated with beneficial changes
in plasma lipids and lipoproteins. Key words:
apolipoprotein; cellulose acetate; dialysis; lipids; lipoprotein lipase
ORIGINAL ARTICLES
Effects of two low-flux cellulose acetate dialysers on plasma lipids and lipoproteins-a cross-over trial
McMaster University, Hamilton, Canada; University of Western Ontario, London, Ontario, Canada; Corresponding author at: Suite 500, 25 Charlton Ave E, Hamilton, Ontario, Canada L8N 1Y2
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  D. Brancaccio, C. Tetta, M. Gallieni, and V. Panichi Inflammation, CRP, calcium overload and a high calcium-phosphate product: a liaison dangereuse' Nephrol. Dial. Transplant., February 1, 2002; 17(2): 201 - 203. [Full Text] [PDF]
|
|
|
|
|
|
A. A. House, G. A. Wells, J. G. Donnelly, S. P. Nadler, and P. C. Hebert Randomized trial of high-flux vs low-flux haemodialysis: effects on homocysteine and lipids Nephrol. Dial. Transplant., July 1, 2000; 15(7): 1029 - 1034. [Abstract] [Full Text] [PDF]
|
|