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 high‑flux polysulfone membrane (Helixone®) compared with those dialyzed with a low‑flux polysulfone membrane.

Patients and methods: This was a crossover randomized study including 90 hemodialysis patients. Group 1 was treated first with high‑flux and then with low‑flux membranes, while group 2, first with low‑flux and then with high‑flux 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 high‑flux dialysis, we observed a significant decrease in β2‑microglobulin, lipoprotein(a), C‑reactive protein, and parathormone levels and an increase in serum albumin levels. Initially, both groups showed left ventricular hypertrophy. After 6 months of high‑flux 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 high‑flux dialysis with the Helixone® membrane, in comparison with low‑flux dialysis with polysulfone membranes, improves middle-molecular clearance. In addition, we showed that a reduction in chronic inflammation during high‑flux dialysis may decrease cardiovascular risk. However, further research with longer follow‑up is needed to verify our echocardiographic findings.