Cardiovascular risk in patients undergoing maintenance hemodialysis with Helixone® membrane: a multicenter randomized study.

ABSTRACT

INTRODUCTION: The high prevalence and incidence of atherosclerotic vascular complications, such as cardiovascular disease, remain the major cause of morbidity and mortality in patients undergoing dialysis. OBJECTIVES: The aim of the study was to evaluate cardiovascular risk factors in patients dialyzed with a high­flux polysulfone membrane (Helixone®) compared with those dialyzed with a low­flux polysulfone membrane. PATIENTS AND METHODS: This was a crossover randomized study including 90 hemodialysis patients. Group 1 was treated first with high­flux and then with low­flux membranes, while group 2, first with low­flux and then with high­flux membranes for 13 months. Clinical, biochemical, and echocardiographic data were evaluated at baseline and every 3 months during the study. RESULTS: After 6 months of high­flux dialysis, we observed a significant decrease in ß2­microglobulin, lipoprotein(a), C­reactive protein, and parathormone levels and an increase in serum albumin levels. Initially, both groups showed left ventricular hypertrophy. After 6 months of high­flux dialysis, we observed a tendency for an increase in the cardiac index and cardiac output and a decrease in isovolumic relaxation time. CONCLUSIONS: Our study showed that the use of high­flux dialysis with the Helixone® membrane, in comparison with low­flux dialysis with polysulfone membranes, improves middle-molecular clearance. In addition, we showed that a reduction in chronic inflammation during high­flux dialysis may decrease cardiovascular risk. However, further research with longer follow­up is needed to verify our echocardiographic findings.