Possible effect of dialysis membrane in polymethylmethacrylate on clinical variables associated with atherosclerosis development in chronic renal failure patients

Abstract

Background: Chronic hemodialysis patients have higher cardiovascular morbidity compared to the general population. A number of studies have suggested that patients undergoing hemodialysis with polymethylmethacrylate (PMMA) membranes have a better outcome compared to other membranes. Methods: We performed a retrospective, multicenter study to evaluate the impact of PMMA membranes compared to other types of membranes on clinical parameters considered important risk factors for the development of cardiovascular disease in chronic kidney disease patients. Results: The study included 104 patients (52 patients on PMMA and 52 patients on other membranes) from ten dialysis centers, monitored for 24 months. HDL cholesterol (mg/dL) increased significantly in the PMMA group (41.4 ± 10.8 to 44.1 ± 13.5, p = 0.0467), but not in the control group (41.8 ± 13.8 to 39.4 ± 9.6, p = 0.8628). At 24 months total cholesterol and triglycerides (mg/dl) were significantly lower in the PMMA group than in the control group (142.4 ± 43.8 vs. 166.1 ± 43.4, p = 0.0321 and 106 (76.5-176) vs. 170 (118-254), p = 0.014), respectively. Serum creatinine (mg/dL) increased significantly from baseline to 24months in the PMMA group (9.20 ± 2.5 to 9.47 ± 2.3, p = 0.0291), but not in the patients treated with other membranes (8.39 ± 2.6 to 8.37 ± 2.3, p = 0.2743). In addition creatinine was significantly higher in the PMMA group compared to the other group (9.47 ± 2.3 vs. 8.37 ± 2.3, p = 0.0493). WBCs (109/L) increased significantly in the control group (6151 ± 1846 to 6672 ± 1872, p = 0.0457) but not in the PMMA group (6326 ± 2113 to 6152 ± 1832, p = 0.8981). At 24 months platelets (109/L) and CRP (ng/dL) were significantly lower in the PMMA group compared to the control group (185 (144-222) vs. 210 (173-259), p = 0.0498 and 0.70 (0.30-1.59) vs. 3.76 (0.46-10.2), p = 0.023, respectively). Iron and transferrin (μ g/dL) decreased signifi cantly in the patients treated with other membrane (62.5 ± 30.4 to 52.6 ±19.0, p = 0.0113 and 178 (157-218) to 170 (124-203), p = 0.0019, respectively), but not in the PMMA group. Conclusion: This retrospective study of data from 104 patients shows a favorable effect of PMMA on clinical variables considered relevant for the development of atherosclerosis in hemodialysis patients.