The effect of XXXX -based protein-leaking dialyzers on plasma @entity1255 levels.

@entity1 @entity4625 @entity1255 @entity5784 @entity3562 @entity65 @entity454
BACKGROUND: @entity3562 is a well-recognized independent risk factor for @entity65 in @entity454 ( @entity454 ) @entity1 . Since @entity1255 ( @entity5784 ) largely binds to serum proteins (80 to 90%), in this study we investigated the possibility that @entity4625 ( @entity4625 )-based protein-leaking dialyzers could reduce total plasma @entity5784 (tHcy) levels in @entity454 @entity1 . METHODS: Two matched groups of @entity1 (N = 13) showing mild to intermediate @entity3562 on standard hemodialysis (HD) with conventional non-protein-leaking dialyzers were included. In the control group membranes were maintained the same, while the study group was switched to protein-leaking dialyzers (BK-F series; Toray, Japan) and studied for 6 months. tHcy was measured by high performance liquid chromatography (HPLC) at baseline and after 1, 3, and 6 months. Proteins and @entity5784 were also measured in the spent dialysate. RESULTS: The pre-HD levels of tHcy in the control group remained close to baseline values (26.6 +/- 5.0 micromol/L), while in the study group at 1, 3, and 6 months they decreased from a baseline value (in micrormol/L) of 25.3 +/- 5.9 to 21.5 +/- 4.5, 16.9 +/- 4.0, and 17.2 +/- 4.2, respectively (P < 0.01 for values at 3 and 6 months vs. baseline). The intra-HD drop of tHcy (Delta HDHcy) slightly but progressively decreased during the 3 steps on protein-leaking dialyzers and a positive correlation was found between Delta HDHcy and pre-HD levels of tHcy. In spent dialysate samples from protein-leaking dialyzer-treated @entity1 , the amount of protein-bound @entity5784 (bHcy) was approximately 10 times higher than in non-protein-leaking dialyzers, but the Delta HDHcy observed in non-protein-leaking dialyzers and protein-leaking dialyzers was comparable. Serum proteins and albumin were only slightly affected by protein-leaking dialyzers. CONCLUSION: This study demonstrates that protein-leaking dialyzers used with a pure diffusive technique significantly lower pre-HD tHcy (approximately 33% of starting levels after 3 months of treatment) in @entity454 @entity1 . A possible underlying mechanism for this effect could be the removal of large molecular weight solutes responsible for a defective metabolism of the @entity5784 , as the removal of bHcy with protein-leaking dialyzers seems not sufficient, per se, to explain this steady reduction of tHcy levels in pre-HD.
