Abstract
Objective: We conducted a prospective multicenter study to evaluate the effects of a vitamin E-bonded polysulfone membrane dialyzer (VPS-HA) on anemia, and the erythropoiesis stimulation agent(ESA) dosage in hemodialysis patients. Methods:The entry criteria were:Patients dialyzed by the same type4 polysulfone dialyzer(type4 PS) for more than three months;patients whose TSAT was more than 20%; those administrated the same ESA over the past three months;and those whose serum hemoglobin ranged from 10 to 12g/dL. A total of 305 hemodialysed patients attending 48 dialysis units fulfilled the entry criteria and were randomly (central registration) assigned to the VPS-HA group or type4 PS group. We observed the dosage for ESA and ERI, which were needed to maintain hemoglobin (range:10 to 11g/dL, or 11 to 12g/dL) at the initial point in each group. The primary outcome was the ESA response at one year. To evaluate the ESA response, the erythropoietic resistance index (ERI) was examined. Results:The VPS-HA group showed a better ESA response, with hemoglobin values between 11 and 12g/dL, than the control type4 PS group. In the VPS-HA group, receiving Darbepoetin alfa as the ESA, the ERI decreased significantly compared with the baseline (8 to 12 months). In the control type4 PS group, the ERI elevated significantly compared with the baseline (with rHuEPO, 5, 7, 10 months). Intergroup comparison was conducted between the control type4 PS group and VPS-HA group, receiving Darbepoetin alfa as the ESA, and the VPS-HA group showed a significant decrease at 11 months compared with control type4 PS group. Conclusions:These observations indicate that the vitamin E-bonded polysulfone dialyzer was more effective than the other type4 polysulfone dialyzer on anemia and the ESA dosage in patients using Darbepoetin alfa, maintaining the hemoglobin range from 11 to 12g/dL.
