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Effect of medium cut-off and high-flux hemodialysis membranes on blood pressure assessed by ambulatory blood pressure monitoring.
Silva, Monique Vércia Rocha; Carvalho, Aluízio Barbosa; Manfredi, Silvia Regina; Cassiolato, José Luiz; Canziani, Maria Eugênia Fernandes.
Afiliação
  • Silva MVR; Department of Nephrology, Federal University of São Paulo, São Paulo, Brazil.
  • Carvalho AB; Department of Nephrology, Federal University of São Paulo, São Paulo, Brazil.
  • Manfredi SR; Department of Nephrology, Federal University of São Paulo, São Paulo, Brazil.
  • Cassiolato JL; Department of Cardiology, Cardios Research Institute, São Paulo, Brazil.
  • Canziani MEF; Department of Nephrology, Federal University of São Paulo, São Paulo, Brazil.
Artif Organs ; 48(5): 433-443, 2024 May.
Article em En | MEDLINE | ID: mdl-38409907
ABSTRACT

BACKGROUND:

Hypertension is one of the most critical risk factors for cardiovascular disease, which is the leading cause of death in hemodialysis (HD) patients. Medium cut-off (MCO) membrane increases the clearance of medium molecules, which could improve blood pressure (BP) control. This study aimed to compare the effect of MCO and high-flux hemodialysis membranes on BP assessed by ambulatory blood pressure monitoring (ABPM).

METHODS:

This is a pre-established secondary analysis of a 28-week, randomized, open-label crossover clinical trial. Patients were randomized to HD with MCO or high-flux membranes over 12 weeks, followed by a 4-week washout period, and then switched to the alternate membrane treatment for 12 weeks. ABPM was started before the HD session and ended at least 24 h later in weeks 1, 12, 16, and 28.

RESULTS:

32 patients, 59% male, with a mean age of 52.7 years, and 40% with unknown CKD etiology, were enrolled. The dialysis vintage was 8 years, and more than 70% of the patients had hypertension. Regarding 24-h BP control, morning diastolic BP showed an increase in the high-flux compared to stability in the MCO group (interaction effect, p = 0.039). The adjusted ANOVA models showed no significant difference in the morning BP levels between the groups. Considering only the period of the HD session, patients in the MCO, compared to those in the high-flux membrane group, showed greater BP stability during dialysis, characterized by smaller variation in the pre-post HD systolic and minimum systolic BP (treatment effect, p = 0.039, and p = 0.023, respectively).

CONCLUSIONS:

MCO membrane seems to have a beneficial effect on morning BP and favors better BP stability during HD sessions.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cefalosporinas / Monitorização Ambulatorial da Pressão Arterial / Hipertensão Limite: Female / Humans / Male / Middle aged Idioma: En Revista: Artif Organs Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cefalosporinas / Monitorização Ambulatorial da Pressão Arterial / Hipertensão Limite: Female / Humans / Male / Middle aged Idioma: En Revista: Artif Organs Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos