Effects of vitamin E-coated membrane dialyser on markers of oxidative stress and inflammation in patients on chronic haemodialysis.

Background: In the present prospective, controlled, observational cohort study, we investigated the effects of the use of a vitamin E-coated membrane dialyser (VEM) on markers of chronic inflammation, oxidative stress and endothelial cell apoptosis in end-stage renal disease (ESRD) patients on chronic haemodialysis (HD), as long as evidence of their effects on these pathogenetic routes are inconclusive as yet, despite their use for the last several years.

Methods: Thirty-five stable ESRD patients underwent HD with the use of VEM for 6 months. Another 25 age- and sex-matched ESRD patients, being dialysed with conventional dialysers, served as controls. In both patient groups, beyond complete haematology and biochemistry work-up, serum CRP, apolipoproteins A1 and B, lipoprotein (a) (Lp(a)), hsIL-6, MCP-1, sICAM-1, sVCAM-1, sE-selectin, sFas and sFasL as well as plasma oxLDL, TBARS and TAS levels were determined at baseline and at 6 months of the study.

Results: In the VEM group at 6 months, a significant reduction in CRP (P = 0.004), IL-6 (P = 0.004) and sICAM-1 (P = 0.04) levels was observed compared with baseline, along with a remarkable change in all markers of oxidative stress, i.e. increase in TAS (P = 0.005) and decrease in TBARS (P = 0.04) and oxLDL (P < 0.001). No significant changes were noted in the other parameters studied in the VEM group or in any parameter studied in the controls. Between the groups, significant differences were found in the change of CRP (P = 0.001), sICAM-1 (P = 0.03) and oxLDL (P = 0.04) compared with baseline.

Conclusions: HD with the use of VEM resulted in a significant reduction in inflammation and oxidative stress markers. Larger prospective randomized studies will need to confirm the findings of the present observational study.