Evaluation of the Effect of the PMMA Dialysis Membrane on the Level of Inflammation in Patients on Hemodialysis

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Article / Publication Details

First-Page Preview

Abstract of Research Article

Received: April 20, 2022
Accepted: February 14, 2023
Published online: March 29, 2023

Number of Print Pages: 6
Number of Figures: 0
Number of Tables: 3

ISSN: 0253-5068 (Print)
eISSN: 1421-9735 (Online)

For additional information: https://www.karger.com/BPU

Abstract

Introduction: The inflammation syndrome is typical for chronic kidney disease (CKD) and increases with the progression of CKD. It is extremely important to monitor the markers of inflammation in patients with CKD, as there is a clear relationship between the level of inflammation and mortality in these patients. Currently, there is no single approach to the treatment of chronic inflammation in patients with CKD. Methods: This was a prospective open cohort study. We studied 31 patients on hemodialysis from March 1, 2020, to August 1, 2021, in 2 Moscow clinics (No. 7 and S.P. Botkin). Inclusion criteria for patients in the study were an adequate dialysis according to the KT/V index ≥1.4, absence of an active inflammatory process or infections, age over 18 years, standard hemodialysis regimen of 3 times per week, at least 4 h, levels of interleukin-6 (IL-6), IL-8, and C-reactive protein (CRP) above the reference values. Patients were transferred from hemodialysis performed using a standard polysulfone (PS) membrane to a polymethylmethacrylate (PMMA) membrane (Filtryzer BK-2.1F). For dialysis treatment in patients, blood flow rates of 250–350 mL/min were used, and the flow rate of the dialysis solution was set at 500 mL/min. The control group consisted of 19 patients, with similar inclusion parameters, who continued their treatment with hemodialysis using a PS membrane. The aim of the research was to study the effect of the dialysis membrane (Filtryzer BK-2.1F) on the level of inflammation in routine practice compared to a PS membrane. Adverse events were monitored. Results: By the end of the study, after 12 months, the levels of cytokines significantly decreased only in patients who had treatment with PMMA membrane, starting from the 3rd month of treatment, and became close to normal levels: IL-6 from 16.9 ± 8.0 to 8.5 ± 4.8 pg/mL (p ≤ 0.0001); IL-8 from 78.5 ± 11.4 to 43.6 ± 11.6 pg/mL (p ≤ 0.0001); and CRP from 10.33 ± 2.83 to 6.15 ± 1.57 mg/L (p ≤ 0.0001). Values of inflammation markers did not change in control group. Conclusion: In our study, we demonstrated for the first time a significant reduction in the level of inflammation in patients on standard hemodialysis in routine practice due to the use of PMMA membranes.

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References Levin A, Tonelli M, Bonventre J, Coresh J, Donner JA, Fogo AB, et al. Global kidney health 2017 and beyond: a roadmap for closing gaps in care, research, and policy. Lancet. 2017;390(10105):1888–917. Shutov E, Yarovaya G, Ermolenko V. The chronic renal failure as inflammation. 5-th interscience world conference on inflammation, antirheumatics. Analgesics, immunomodulators Geneva. -Abs.; 1993. p. 225. Stenvinkel P, Heimbürger O, Paultre F, Diczfalusy U, Wang T, Berglund L, et al. Strong association between malnutrition, inflammation, and atherosclerosis in chronic renal failure. Kidney Int. 1999;55(5):1899–911. Zimmermann J, Herrlinger S, Pruy A, Metzger T, Wanner C. Inflammation enhances cardiovascular risk and mortality in hemodialysis patients. Kidney Int. 1999;55(2):648–58. Cobo G, Lindholm B, Stenvinkel P. Chronic inflammation in end-stage renal disease and dialysis. Nephrol Dial Transpl. 2018;33(Suppl 3):iii35–40. Kalantar-Zadeh K, Stenvinkel P, Pillon L, Kopple JD. Inflammation and nutrition in renal insufficiency. Adv Ren Replace Ther. 2003;10(3):155–69. Gupta J, Mitra N, Kanetsky PA, Devaney J, Wing MR, Reilly M, et al. Association between albuminuria, kidney function, and inflammatory biomarker profile in CKD in CRIC. Clin J Am Soc Nephrol. 2012;7(12):1938–46. Mihai S, Codrici E, Popescu ID, Enciu AM, Albulescu L, Necula LG, et al. Inflammation-related mechanisms in chronic kidney disease prediction, progression, and outcome. J Immunol Res. 2018;2018(2):2180373–16. Carrero JJ, Stenvinkel P. Inflammation in end-stage renal disease: what have we learned in 10 years? Semin Dial. 2010;23(5):498–509. Lisowska-Myjak B. Uremic toxins and their effects on multiple organ systems. Nephron Clin Pract. 2014;128(3–4):303–11. Anders HJ, Andersen K, Stecher B. The intestinal microbiota, a leaky gut, and abnormal immunity in kidney disease. Kidney Int. 2013;83(6):1010–6. Jankowska M, Cobo G, Lindholm B, Stenvinkel P. Inflammation and protein-energy wasting in the uremic milieu. Contrib Nephrol. 2017;191:58–71. Matsuda K, Hirasawa H, Oda S, Shiga H, Nakanishi K. Current topics on cytokine removal technologies. Ther Apher. 2001;5(4):306–14. Kooman JP, Dekker MJ, Usvyat LA, Kotanko P, van der Sande FM, Schalkwijk CG, et al. Inflammation and premature aging in advanced chronic kidney disease. Am J Physiol Ren Physiol. 2017;313(4):F938–50. Vanholder R, De Smet R, Glorieux G, Argilés A, Baurmeister U, Brunet P, et al. Review on uremic toxins: classification, concentration, and interindividual variability. Kidney Int. 2003;63(5):1934–43. Castillo-Rodríguez E, Pizarro-Sánchez S, Sanz AB, Ramos A, Sanchez-Niño MD, Martin-Cleary C, et al. Inflammatory cytokines as uremic toxins: “Ni son todos los que estan, Ni estan todos los que son.” Toxins. 2017;9(4):E114. Stenvinkel P, Ketteler M, Johnson RJ, Lindholm B, Pecoits-Filho R, Riella M, et al. IL-10, IL-6, and TNF-alpha: central factors in the altered cytokine network of uremia–the good, the bad, and the ugly. Kidney Int. 2005;67(4):1216–33. Cohen SD, Phillips TM, Khetpal P, Kimmel PL. Cytokine patterns and survival in haemodialysis patients. Nephrol Dial Transpl. 2010;25(4):1239–43. Pecoits-Filho R, Barany P, Lindholm B, Heimburger O, Stenvinkel P. Interleukin-6 is an independent predictor of mortality in patients starting dialysis treatment. Nephrol Dial Transpl. 2002;17(9):1684–8. Memoli B, Grandaliano G, Soccio M, Postiglione L, Guida B, Bisesti V, et al. In vivo modulation of soluble “antagonistic” IL-6 receptor synthesis and release in ESRD. J Am Soc Nephrol. 2005;16(4):1099–107. In Duranton F, Cohen G, De Smet R, Rodriguez M, Jankowski J, Vanholder R, et al. Normal and pathologic concentrations of uremic toxins. J Am Soc Nephrol. 2012;23(7):1258–70. Apostolakis S, Vogiatzi K, Amanatidou V, Spandidos DA. Interleukin 8 and cardiovascular disease. Cardiovasc Res. 2009 Dec 01;84(3):353–60. Gerszten RE, Garcia-Zepeda EA, Lim YC, Yoshida M, Ding HA, Gimbrone MA Jr, et al. MCP-1 and IL-8 trigger firm adhesion of monocytes to vascular endothelium under flow conditions. Nature. 1999;398(6729):718–23. Yue TL, Wang X, Sung CP, Olson B, McKenna PJ, Gu JL, et al. Interleukin-8. A mitogen and chemoattractant for vascular smooth muscle cells. Circ Res. 1994;75:1–7. Moreau M, Brocheriou I, Petit L, Ninio E, Chapman MJ, Rouis M. Interleukin-8 mediates downregulation of tissue inhibitor of metalloproteinase-1 expression in cholesterol-loaded human macrophages: relevance to stability of atherosclerotic plaque. Circulation. 1999;99(3):420–6. Damås JK, Gullestad L, Ueland T, Solum NO, Simonsen S, Frøland SS, et al. CXC-chemokines, a new group of cytokines in congestive heart failure: possible role of platelets and monocytes. Cardiovasc Res. 2000;45(2):428–36. Nymo SH, Hulthe J, Ueland T, McMurray J, Wikstrand J, Askevold ET, et al. Inflammatory cytokines in chronic heart failure:interleukin-8 is associated with adverse outcome. Results from CORONA. Eur J Heart Fail. 2014;16(1):68–75. Panichi V, Taccola D, Rizza GM, Consani C, Ghiadoni L, Filippi C, et al. Interleukin-8 is a powerful prognostic predictor of all-cause and cardiovascular mortality in dialytic patients. Nephron Clin Pract. 2006;102(2):51–c58. Kishikawa T, Fujieda H, Sakaguchi H. Comprehensive analysis of cytokine adsorption properties of polymethyl methacrylate (PMMA) membrane material. J Artif Organs. 2022;25(4):343–9. Moriyama K, Kato Y, Hasegawa D, Kurimoto Y, Kawaji T, Nakamura T, et al. Involvement of ionic interactions in cytokine adsorption of polyethyleneimine-coated polyacrylonitrile and polymethyl methacrylate membranes in vitro. J Artif Organs. 2020;23(3):240–6. Harm S, Schildböck C, Hartmann J. Cytokine removal in extracorporeal blood purification: an in vitro study. Blood Purif. 2020;49(1–2):33–43. Article / Publication Details

First-Page Preview

Abstract of Research Article

Received: April 20, 2022
Accepted: February 14, 2023
Published online: March 29, 2023

Number of Print Pages: 6
Number of Figures: 0
Number of Tables: 3

ISSN: 0253-5068 (Print)
eISSN: 1421-9735 (Online)

For additional information: https://www.karger.com/BPU

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