Nephrol Dial Transplant (2000) 15: 2020-2028
© 2000 European Renal Association-European Dialysis and Transplant Association
Blood oxidative stress and lipoprotein oxidizability in haemodialysis patients: effect of the use of a vitamin E-coated dialysis membrane
1 Laboratoire de Biochimie, Hôpital de la Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, 2 Laboratoire de Biochimie Métabolique et Clinique, Faculté de Pharmacie, Paris, 3 Nephrotek, Rungis, 4 Service de Néphrologie Dialyse, Hôpital René Dubos, Pontoise and 5 Service de Néphrologie Dialyse, Centre Hospitalier Marc Jacquet, Melun, France
Background. Oxidative stress has been shown in haemodialysis patients in relation with an increased production of free radicals due to membrane-induced complement and leukocyte activation. In order to minimize membrane bioincompatibility and thereby oxidative stress, more compatible filters have been perfected. Among them, a high-flux vitamin E-coated membrane (CL-EE) has been proposed recently. In vivo, little data is available on the consequences of the use of vitamin E-coated membranes. In the present study, the effects of a 3-month use of CL-EE dialysis membranes compared to conventional membranes have been evaluated in 12 haemodialysis patients on the blood oxidative stress status before and after the dialysis session.
Methods. We determined the lipid peroxidation status (plasma thiobarbituric acid-reactive substances) and antioxidant defence (erythrocyte Cu,Zn-superoxide dismutase and plasma and erythrocyte glutathione peroxidase activities, plasma vitamin E, ß-carotene, vitamin A and total antioxidant status). Also, we simultaneously determined the antioxidant content and the copper oxidizability of isolated low density- and high density-lipoproteins (LDLs and HDLs).
Results. The main consequence observed under these conditions was a marked enrichment of plasma with vitamin E, which was also significantly and selectively noted in HDLs (no changes in LDL vitamin E content), perhaps related to a specific storage capacity for vitamin E in HDLs of haemodialysis patients. The ß-carotene content of plasma, LDLs and HDLs was also higher after use of vitamin E-coated membranes than after use of high-flux biocompatible membranes. HDL copper oxidizability was reduced (as shown by an increased lag time) before dialysis after use of CL-EE membranes compared to conventional membranes, whereas LDL oxidizability remained unchanged.
Conclusion. A 3-month use of vitamin E-coated membranes resulted in a significant increase in plasma and HDL vitamin E content, associated with a lower oxidizability of HDLs, which could be beneficial for haemodialysis patients.
Keywords: antioxidant; haemodialysis; high density lipoprotein; lipid peroxidation; low density lipoprotein; vitamin E
Correspondence and offprint requests to: Dominique Bonnefont-Rousselot, Laboratoire de Biochimie, Hôpital de la Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), 47 boulevard de l'Hôpital, F-75651 Paris Cedex 13, France.
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