Effects of Different Dialysis Membranes on Lipid and Lipoprotein Serum Profiles in Hemodialysis Patients

Abstract

We measured the serum concentrations of a variety of lipid constituents – total cholesterol, triglycerides, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein cholesterol, apolipoproteins A1 and B, and lipoprotein(a) – in well-matched uremic patients undergoing chronic hemodialysis with either cuprophane (n = 13) or polysulfone (n = 13) membranes. We found that the patients on polysulfone membrane dialysis had significantly higher mean HDL cholesterol and apolipoprotein A1 concentrations than the patients on cuprophane membrane dialysis. There were no significant differences in the other variables studied. Moreover, polysulfone membrane dialysis was associated with a lower prevalence of potentially atherogenic lipid abnormalities such as low HDL cholesterol levels and high total cholesterol/HDL cholesterol rations. We concluded that the use of more physiological dialysis procedure may improve, in the long term, lipid and lipoprotein profiles in hemodialysis patients, though the exact mechanism(s) remains unknown.

The relationship between atherogenic index of plasma and epicardial adipose tissue in hemodialysis and peritoneal dialysis patients

“…It has also been demonstrated that the use of high-flux membranes is closely associated with a significant reduction in serum triglyceride levels as well as by an increase in HDL-cholesterol levels. 25,26 This improvement might be attributed to an increase in the apolipoprotein C-II/C-III ratio which increases the activity of lipoprotein lipase and facilitates the intravascular lipolysis of triglyceriderich lipoproteins and the type of dialysate that may significantly affect the serum levels of lipoproteins in this population. 4 Additionally, chronic heparin usage during HD sessions might be another important factor in which heparin releases lipoprotein lipase from the endothelial surface and this may result in defective catabolism of triglyceride-rich lipoproteins via decreasing the serum levels of lipoprotein lipase.…”

Dyslipidemia in Chronic Kidney Disease: An Approach to Pathogenesis and Treatment

“…Thus, it has been shown that the use of high-flux polysulfone or cellulose triacetate membranes instead of low-flux membranes is accompanied by a significant reduction in serum triglyceride levels as well as by an increase in apolipoprotein AI and HDL-cholesterol levels [86, 87]. This improvement could, at least in part, be attributed to an increase in the apolipoprotein C-II/C-III ratio which increases the activity of lipoprotein lipase and facilitates the intravascular lipolysis of triglyceride rich-lipoproteins [88].…”

The impact of haemodialysis-associated variables on lipid profile in Egyptian haemodialysis population

“…[49]. This disharmony might be attributed to their shorter study duration in comparison to us (3 vs. 9 months) an explanation put forward by Docci and co-workers (1995) who concluded that only long-term dialysis induced the noticed lipid parameters improvements [50].…”