Relation of middle molecules levels and oxidative stress to erythropoietin requirements in high-flux versus low-flux hemodialysis

Saudi J Kidney Dis Transpl. 2013 Sep;24(5):930-7. doi: 10.4103/1319-2442.118082.

Abstract

The objective of this study is to investigate the serum beta-2-microglobulin (B2MG) and advanced oxidation protein products (AOPP) as middle molecule uremic toxins and protein carbonyl (PCO) as oxidative stress marker in uremic patients undergoing high-flux versus low-flux hemodialysis (HD) and to correlate their levels to the erythropoietin requirements for those patients. Twenty patients on chronic low-flux HD were recruited in the study. At the start of the study, all patients underwent high-flux HD for eight weeks, followed by low-flux HD for two weeks as a washout period. The patients were then subjected to another eight weeks of low-flux HD. Blood samples were obtained at the beginning and at the end of the high-flux period and the low-flux period. The mean erythropoietin dose for patients using high-flux HD was significantly lower than that for low-flux HD (P = 0.0062). Post-high flux, the B2MG and PCO levels were significantly lower than the pre-high-flux levels (P = 0.026 and 0.0005, respectively), but no significant change was observed in AOPP (P = 0.68). Post-low flux, the B2MG, AOPP and PCO were significantly higher than the pre-low-flux levels (P = 0.0002, 0.021 and <0.0001, respectively). Post-low flux, the B2MG and PCO were significantly higher than the post-high-flux levels (P <0.0001), but no significant difference was observed in AOPP (P = 0.11). High-flux HD results in reduction of some of the middle molecule toxins and PCO levels better than low-flux HD, and is associated with a better response to erythropoietin.

Publication types

  • Comparative Study

MeSH terms

  • Advanced Oxidation Protein Products / blood*
  • Cross-Over Studies
  • Erythropoietin / administration & dosage*
  • Female
  • Humans
  • Male
  • Membranes, Artificial
  • Oxidative Stress
  • Protein Carbonylation / physiology
  • Renal Dialysis / methods*
  • Toxins, Biological / blood*
  • Uremia / blood
  • Uremia / therapy*
  • beta 2-Microglobulin / blood*

Substances

  • Advanced Oxidation Protein Products
  • Membranes, Artificial
  • Toxins, Biological
  • beta 2-Microglobulin
  • uremia middle molecule toxins
  • Erythropoietin