The effect of PMMA-based protein-leaking dialyzers on plasma homocysteine levels

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