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Abstract: SA-PO1019

Vitamin E Polysulfone Dialyzer Improves Erythropoietin Hyporesponsiveness in CKD Patients on Dialysis with Low-Grade Inflammation

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Cristol, Jean-Paul, University Hospital Center of Montpellier, Montpellier, France
  • Morena, Marion, University Hospital Center of Montpellier, Montpellier, France

Group or Team Name

  • on behalf of the EVIA study and VIVRE cohort
Background

This work aimed at evaluating vitamin E-coated polysulfone (PS) membrane (VItabranE®, VIE) effect on erythropoietin hyporesponsiveness through two prospective multicenter studies, one controlled randomized study (Study-1) and one observational study (Study-2) in chronic kidney disease patients on dialysis with low grade inflammation after a 12-month period.

Methods

Study-1. 60 dialysis patients with CRP level in the range [5-20] mg/L were randomly assigned in a 1:1 ratio to either PS control 'C' group (n=30) or 'VIE' group (n=30).
Study-2. 148 eligible dialysis patients out of a total of 244 included, with mean baseline CRP level at 11+12 mg/L and with EPO overconsumption were dialysed with VIE.
Administered EPO dose was recorded and blood samples withdrawn at inclusion and after 3, 6, 9 and 12 months of treatment in both studies.

Results

After a 12-month treatment, VIE use was associated to a reduction in EPO doses in both studies.
In Study-1, we observed a ΔEPO dose at -2710.5+3983.7 IU (p=0.011) corresponding to a 24% reduction when comparing M12 and M0 in VIE group vs -1074.5+5151.4 IU (p=NS) in C group. No improvement in inflammatory markers (CRP, IL-6, TNF-alpha and fibrinogen) or impairement of nutritional parameters (albumin and transthyretin) were observed over the period.
In Study-2, a 28% EPO reduction (p=0.001) was reported when comparing M12 and M0, associated to a 31% iron dose reduction (p=0.002) and stable hemoglobin and serum iron levels. Here again, no improvement in CRP level was obtained.

Conclusion

Both multicenter prospective studies confirm that vitamin E-coated PS membrane can improve EPO efficacy in dialysis patients with low grade inflammation. Such positive effect appears independent of inflammation and nutritional parameters but associated with an improvement of iron metabolism.

Funding

  • Commercial Support