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Titolo High-efficiency on-line haemodiafiltration improves conduit artery endothelial function compared with high-flux haemodialysis in end-stage renal disease patients
Autore Jeremy Bellien, Caroline Freguin-Bouilland, Robinson Joannides, Melanie Hanoy, Isabelle Remy-Jouet, Christelle Monteil, Michele Iacob, Laurent Martin, Sylvanie Renet, Cathy Vendeville, Michel Godin, Christian Thuille, and Frank Le Roy
Referenza Nephrol Dial Transplant 2013; doi: 10.1093/ndt/gft448
Contenuto

Background. Middle molecular weight uraemic toxins are considered to play an important role in vascular dysfunction and cardiovascular outcomes in end-stage renal disease (ESRD) patients. Recent dialysis techniques based on convection, specifically high-efficiency on-line haemodiafiltration (HDF), enhance the removal of middle molecular weight toxins and reduce all-cause mortality in haemodialysis (HD) patients. However, the mechanisms of these improved outcomes remain to be established.

Methods. This prospective study randomly assigned 42 ESRD patients to switch from high-flux HD to high-efficiency Background. Middle molecular weight uraemic toxins are considered to play an important role in vascular dysfunction and cardiovascular outcomes in end-stage renal disease (ESRD) patients. Recent dialysis techniques based on convection, specifically high-efficiency on-line haemodiafiltration (HDF), enhance the removal of middle molecular weight toxins and reduce all-cause mortality in haemodialysis (HD) patients. However, the mechanisms of these improved outcomes remain to be established.

Methods. This prospective study randomly assigned 42 ESRD patients to switch from high-flux HD to high-efficiency kinase C β2, an endothelial NO-synthase (eNOS) inhibitor, decreased significantly with HDF.

Conclusions. High-efficiency on-line HDF prevents the endothelial dysfunction and stiffening of the conduit arteries in ESRD patients compared with high-flux HD. HDF decreases uraemic toxins, vascular inflammation, and is associated with subsequent improvement in eNOS functionality. These results suggest that reduced endothelial dysfunction may be an intermediate mechanism explaining the beneficial outcomes associated with HDF.

Data 04.07.2014
 
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