Influence of Different Haemodialysis Modalities on AGE Peptide Levels: Intradialytic versus Long-Term Results

Abstract

Background: Peptide-linked degradation products of advanced glycation end products (AGE peptides) accumulate in chronic haemodialysis (HD) patients and may contribute to a number of HD-related long-term complications, such as accelerated atherosclerosis. Methods: The influence of a single HD session versus long-term HD on serum AGE peptides was determined. The patients were randomized to HD with a low-flux polysulfone (PS; F 6HPS), a high-flux PS (F 60S), a superflux PS (F 500S), or a superflux cellulose triacetate (CTA; Tricea 150G) dialyzer. Results: During a single HD session, both AGE peptides and reference peptides decreased significantly (AGE peptides: Tricea 150G –37.0 ± 2.9%; F 6HPS –35.5 ± 2.4%; F 60S –39.5 ± 4.7%, and F 500S –43.3 ± 2.1%, p = 0.005; reference peptides: Tricea 150G –73.2 ± 8.8%; F 6HPS –73.2 ± 7.9%; F 60S –72.5 ± 8.2%, and F 500S –74.1 ± 7.3%, p = 0.005). After 12 weeks of HD with the superflux CTA, the AGE peptide levels decreased significantly (week 1: 2.7 ± 1.1 arbitrary units, week 12: 2.5 ± 1.2 arbitrary units, decrease 7.4%; p = 0.01), whereas the AGE peptide levels remained unchanged after HD with each of the other three modalities. The reference peptide levels did not change after 12 weeks of HD. Conclusion: Although AGE peptides can be effectively removed during a single HD session, superflux CTA seems to be the only modality capable of reducing AGE peptides in the long term.

Convective therapies versus low-flux hemodialysis for chronic kidney failure: a meta-analysis of randomized controlled trials

“…Two hundred and ninety-one articles were retrieved for detailed evaluation, of which 65 fulfilled eligibility criteria comprising 29 crossover and 36 parallel-arm randomized controlled trials [9][10][11] (Figure 1). Eight trials had two different convective treatment groups [19,25,36,37,42,57,71,73], and three trials had three different convective treatment groups [43,47,54] (Table 1). One trial reported separately on two different outcomes [41,50].…”

The influence of body mass index on the accumulation of advanced glycation end products in hemodialysis patients

“…Super-flux and protein-leaking membranes have been suggested to be a modality capable of reducing AGE peptides in the long term. [27][28][29][30] In addition, single dialysis session with online hemodiafiltration (HDF) results in lower plasma AGE than with those treated with conventional low-and high-flux HD. The long-term use of HDF provides lower predialysis plasma AGE levels compared with those treated with low-and high-flux HD.…”