The influence of vitamin E-coated dialysis membrane on oxidative stress during a single session of on-line hemodiafiltration

Svetlana Antić; Nevena Draginić; Dejan Pilčević; Vladimir Živković; Ivan Srejović; Nevena Jeremić; Dejan Petrović; Vladimir Jakovljević

doi:10.2298/VSP190730097A

Svetlana Antić Military Medical Academy, Clinic for Nephrology, Belgrade, Serbia
Nevena Draginić University of Kragujevac, Faculty of Medical Sciencies, Department of Pharmacy, Kragujevac, Serbia
Dejan Pilčević Military Medical Academy, Clinic for Nephrology, Belgrade, Serbia
Vladimir Živković University of Kragujevac, Faculty of Medical Sciencies, Department of Physiology, Kragujevac, Serbia
Ivan Srejović University of Kragujevac, Faculty of Medical Sciencies, Department of Physiology, Kragujevac, Serbia
Nevena Jeremić University of Kragujevac, Faculty of Medical Sciencies, Department of Pharmacy, Kragujevac, Serbia
Dejan Petrović University of Kragujevac, Faculty of Medical Sciencies, Department of Internal Medicine, Kragujevac, Serbia
Vladimir Jakovljević University of Kragujevac, Faculty of Medical Sciencies, Department of Physiology, Kragujevac, Serbia

DOI: https://doi.org/10.2298/VSP190730097A

Keywords: hemodiafiltration, membranes, artificial, oxidative stress, vitamin e

Abstract

Background/Aim. Oxidative stress is an important risk factor for the development of cardiovascular atherosclerotic diseases in the population of patients treated with regular hemodialysis. Bioincompatibility of the dialysis membrane and increased concentration of endotoxin in the hemodialysis solution are two main factors that can trigger oxidative stress. This paper was intended to examine the effect of a vitamin E-coated membrane on oxidative stress during a single session of on-line hemodiafiltration. Methods. Twenty-four patients undergoing hemodiafiltration with vitamin E-coated polysulfone dialysis membrane (Leoceed 21H) were examined, followed by a polysulfone dialysis membrane treatment without vitamin E (FX800). The following parameters of oxidative stress were measured: superoxide anion radical (O₂^-), hydrogen peroxide (H₂O₂), thiobarbutyric acid reactive substances (TBARS), nitric oxide (NO₂^-), catalase (CAT), superoxide dizmutase (SOD), and reduced glutathione (GSH) activity. Statistical analysis included the Kolmogorov-Smirnov test, Student-t test and Wilcoxon test. Results. On-line hemodiafiltration using a high-flux polysulfone vitamin E-coated membrane led to significant reduction of TBARS concentration and SOD activity, while the on-line hemodiafiltration session using a high-flux polysulfone membrane that is not vitamin E-coated induced a significant increase in H₂O₂concentration in the serum and a decrease in SOD activity. There was no statistical significance among the other parameters of oxidative stress. Conclusion. A single session of on-line hemodiafiltration using a vitamin E-coated polysulfone membrane significantly affects oxidative stress. After a single session of on-line hemodiafiltration using a vitamin E-coated membrane, the concentration of TBARS has significantly decreased. The decreased activity of superoxide dismutase could be a consequence of an increased loss of microelements during an on-line hemodiafiltration session using a high-flux polysulfone membrane. Patient selection, continuous on-line hemodiafiltration using a vitamin E-coated polysulfone membrane over a 3–6 month period and increased antioxidant protection capacity could possibly reduce the risk of cardiovascular morbidity and mortality in patients treated by hemodialysis.

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