Effects of Hemodiafiltration of Inflammation and Oxidative Stress

Davenport, Andrew

doi:10.1007/978-3-319-23332-1_13

Cited by 5 publications

(6 citation statements)

References 47 publications

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“…The previous studies had shown that selenium, zinc, or L-carnitine supplementation after each HD session for 2-3 months increase the capacity of enzymatic antioxidant protection and the status of malnutrition and decrease the resistance to EPO [ 36 – 38 ] which accentuate the fact that OS development leads to EPO resistance, as we concluded regarding the results of our study. Moreover, high-flux HD and post-dilution online hemodiafiltration with vitamin E-coated dialysis membranes significantly reduce OS and microinflammation, increase iron availability for erythropoiesis, reduce EPO resistance, and improve nutritional status, quality of life, and the outcome of patients treated with regular dialysis [ 39 – 41 ], which all together imply role of OS in the development of EPO resistance, as we concluded in our study.…”

Section: Discussionsupporting

confidence: 59%

Erythropoietin Resistance Development in Hemodialysis Patients: The Role of Oxidative Stress

Jovic

Antić

Nikolić

et al. 2022

Oxidative Medicine and Cellular Longevity

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Oxidative stress (OS) is considered a significant risk factor for the development of anemia in patients treated by regular hemodialysis (HD). Moreover, OS represents a risk factor for the development of erythropoietin (EPO) resistance in these patients. The aim of this study was to examine the role of OS regarding EPO resistance development in patients treated by regular HD. 96 patients treated with standard HD and on-line hemodiafiltration were included in this study. The patients were treated with short-acting and long-acting EPOs for anemia. The concentration of superoxide anion radical, hydrogen peroxide, thiobarbituric acid reactive substances, and nitric oxide in the form of nitrites and the activity of catalase, superoxide dismutase and reduced glutathione were measured in patients’ blood spectrophotometrically. Standard biochemical analysis, inflammatory markers, nutritional status, HD parameters, and erythropoietin resistance index were also determined. Patients with resistance to short-acting EPO had significantly lower concentration of hemoglobin in the blood and hematocrit value, a significantly higher serum ferritin concentration, and significantly lower catalase activity in erythrocytes than patients without EPO resistance. Patients with resistance to long-acting EPO have a significantly lower hemoglobin concentration in the blood, hematocrit values, and serum concentration of prealbumin and vitamin D, as well as significantly higher concentration of C-reactive protein, superoxide anion, and hydrogen peroxide concentration than those without resistance. OS significantly contributes to EPO resistance development. OS, higher ferritin and CRP levels, lower hemoglobin, hematocrit and prealbumin levels, and vitamin D deficiency represent significant risk factors for EPO resistance development in HD patients.

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Section: Discussionsupporting

confidence: 59%

Erythropoietin Resistance Development in Hemodialysis Patients: The Role of Oxidative Stress

Jovic

Antić

Nikolić

et al. 2022

Oxidative Medicine and Cellular Longevity

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“…In agreement with these results, another study showed that post‐dilution HDF for 9 months in a small cohort of nine chronic HD patients resulted in significant suppression of OS, improved TAC and decreased inflammation . Davenport et al, suggested that compared to conventional HD, post‐dilution HDF is accompanied by significantly less OS . Compared to conventional HD, the data available suggest that HDF has important beneficial effect on OS and chronic inflammation.…”

Section: Hemodialysis Procedures and Osmentioning

confidence: 61%

“…There is a growing body of evidence suggesting that, compared to standard HD, HDF with online regeneration of ultrafiltrate has a positive impact on OS and inflammation in chronic HD patients . This is attributed to the use of more biocompatible dialyzers and ultrapure dialysate, the improved hemodynamics and anemia and better clearance of circulating large molecular weight molecules, such as inflammatory mediators, homocysteine, and others …”

Section: Hemodialysis Procedures and Osmentioning

confidence: 99%

“…72 This is attributed to the use of more biocompatible dialyzers and ultrapure dialysate, the improved hemodynamics and anemia and better clearance of circulating large molecular weight molecules, such as inflammatory mediators, homocysteine, and others. [72][73][74][75][76] Gonzalez-Diez et al, conducted a multicenter study to investigate the possible beneficial antioxidant effect of HDF, compared to conventional HD session using polysulfone membranes. Forty stable patients undergoing maintenance HD in seven different hospitals were divided into two groups: 25 treated with HDF and 15 with conventional HD.…”

Section: Hemodiafiltration (Hdf)mentioning

confidence: 99%

“…76 Davenport et al, suggested that compared to conventional HD, post-dilution HDF is accompanied by significantly less OS. 73 Compared to conventional HD, the data available suggest that HDF has important beneficial effect on OS and chronic inflammation. However, part of this beneficial effect could be attributed to the use of more biocompatible dialyzers and ultrapure dialysate that are inherent in the case of HDF.…”

Section: Hemodiafiltration (Hdf)mentioning

confidence: 99%

See 2 more Smart Citations

Oxidative stress in hemodialysis: Causative mechanisms, clinical implications, and possible therapeutic interventions

Liakopoulos

Roumeliotis

Zarogiannis

et al. 2018

Seminars in Dialysis

103

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Oxidative stress (OS) is the result of prooxidant molecules overwhelming the antioxidant defense mechanisms. Hemodialysis (HD) constitutes a state of elevated inflammation and OS, due to loss of antioxidants during dialysis and activation of white blood cells triggering production of reactive oxygen species. Dialysis vintage, dialysis methods, and type and condition of vascular access, biocompatibility of dialyzer membrane and dialysate, iron administration, and anemia all can play a role in aggravating OS, which in turn has been associated with increased morbidity and mortality. Oral or intravenous administration of antioxidants may detoxify the oxidative molecules and at least in part repair OS‐mediated tissue damage. Lifestyle interventions and optimization of a highly biocompatible HD procedure might ameliorate OS development in dialysis.

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Oxidative Stress in Hemodialysis Patients: A Review of the Literature

Liakopoulos

Roumeliotis

Gorny

et al. 2017

Oxidative Medicine and Cellular Longevity

212

230

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Hemodialysis (HD) patients are at high risk for all-cause mortality and cardiovascular events. In addition to traditional risk factors, excessive oxidative stress (OS) and chronic inflammation emerge as novel and major contributors to accelerated atherosclerosis and elevated mortality. OS is defined as the imbalance between antioxidant defense mechanisms and oxidant products, the latter overwhelming the former. OS appears in early stages of chronic kidney disease (CKD), advances along with worsening of renal failure, and is further exacerbated by the HD process per se. HD patients manifest excessive OS status due to retention of a plethora of toxins, subsidized under uremia, nutrition lacking antioxidants and turn-over of antioxidants, loss of antioxidants during renal replacement therapy, and leukocyte activation that leads to accumulation of oxidative products. Duration of dialysis therapy, iron infusion, anemia, presence of central venous catheter, and bioincompatible dialyzers are several factors triggering the development of OS. Antioxidant supplementation may take an overall protective role, even at early stages of CKD, to halt the deterioration of kidney function and antagonize systemic inflammation. Unfortunately, clinical studies have not yielded unequivocal positive outcomes when antioxidants have been administered to hemodialysis patients, likely due to their heterogeneous clinical conditions and underlying risk profile.

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Effects of Hemodiafiltration of Inflammation and Oxidative Stress

Cited by 5 publications

References 47 publications

Erythropoietin Resistance Development in Hemodialysis Patients: The Role of Oxidative Stress

Erythropoietin Resistance Development in Hemodialysis Patients: The Role of Oxidative Stress

Oxidative stress in hemodialysis: Causative mechanisms, clinical implications, and possible therapeutic interventions

Oxidative Stress in Hemodialysis Patients: A Review of the Literature

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