Orta Geçirgen Diyaliz Membranı İle Diyalize Giren Hastaların Kan İnflamatuvar Belirteç Düzeylerinin Ve Arteriyal Kompliyanslarının Değerlendirilmesi

Abstract

Cardiovascular diseases are the main cause of morbidity and mortality in patients with end-stage renal disease undergoing hemodialysis. Although significant advances have been made in hemodialysis treatment, survival and quality of life have improved compared to the past, the results are still unsatisfactory. Medium cut-off dialysis membranes are one of the new treatment approaches in the hemodialysis process, which are developed to ensure the removal of medium molecular weight uremic toxins that cannot be removed from the body with standard dialysis membranes and play a role in the development of various uremic complications. In this study, the effects of medium cut-off dialysis membranes on inflammatory markers in the blood, cardiac function and arterial stiffness were investigated by comparing the patients undergoing dialysis with medium cut-off and standard dialysis membranes at Hacettepe University Nephrology Department Hemodialysis Unit. A total of 50 patients, 25 patients for both groups, were included in the study. In the group undergoing dialysis with a medium cut-off dialysis membrane, β-2 microglobulin levels (p<0.01), a medium molecular weight uremic toxin, and serum CRP (p<0.001), Interleukin-18 (p<0.05) and Pentraxin-3 (p<0.01) levels were found to be significantly lower. In addition, pulse wave velocity (p<0.01) and augmentation index (p<0.05) values, which are indicators of arterial stiffness, were found to be significantly lower in patients undergoing dialysis with a medium-permeable dialysis membrane. This difference in arterial stiffness markers may be related to the suppression of inflammation by the medium cut-off membranes and the improvement of endothelial functions. In conclusion, when compared with standard dialysis membranes, moderately permeable dialysis membranes may provide an advantage in long-term cardiovascular morbidity and mortality in hemodialysis patients due to their anti-inflammatory effects.

Cardiovascular diseases are the main cause of morbidity and mortality in patients with end-stage renal disease undergoing hemodialysis. Although significant advances have been made in hemodialysis treatment, survival and quality of life have improved compared to the past, the results are still unsatisfactory. Medium cut-off dialysis membranes are one of the new treatment approaches in the hemodialysis process, which are developed to ensure the removal of medium molecular weight uremic toxins that cannot be removed from the body with standard dialysis membranes and play a role in the development of various uremic complications. In this study, the effects of medium cut-off dialysis membranes on inflammatory markers in the blood, cardiac function and arterial stiffness were investigated by comparing the patients undergoing dialysis with medium cut-off and standard dialysis membranes at Hacettepe University Nephrology Department Hemodialysis Unit. A total of 50 patients, 25 patients for both groups, were included in the study. In the group undergoing dialysis with a medium cut-off dialysis membrane, β-2 microglobulin levels (p<0.01), a medium molecular weight uremic toxin, and serum CRP (p<0.001), Interleukin-18 (p<0.05) and Pentraxin-3 (p<0.01) levels were found to be significantly lower. In addition, pulse wave velocity (p<0.01) and augmentation index (p<0.05) values, which are indicators of arterial stiffness, were found to be significantly lower in patients undergoing dialysis with a medium-permeable dialysis membrane. This difference in arterial stiffness markers may be related to the suppression of inflammation by the medium cut-off membranes and the improvement of endothelial functions. In conclusion, when compared with standard dialysis membranes, moderately permeable dialysis membranes may provide an advantage in long-term cardiovascular morbidity and mortality in hemodialysis patients due to their anti-inflammatory effects.