HIGH-FLUX DIALYSIS MEMBRANES IMPROVE LIPID PROFILE IN CHRONIC-HEMODIALYSIS PATIENTS

In a controlled prospective trial, the effect of a switch from cellulo se-based, low-flux dialysis membranes to polysulphone, high-flux membr anes on lipid parameters was evaluated, Baseline values of lipid param eters were identical in the study group and the control group in which the dialysis membrane remained unchanged. After 6 wk, total triglycer ide, very low-density lipoprotein (VLDL) triglyceride, and VLDL choles terol decreased, respectively, 28 +/- 17 (P < 0.01), 38 +/- 17 (P < 0. 01), and 24 +/- 21% (P < 0.05), and the proportion of total cholestero l that was high-density lipoprotein cholesterol increased from 15 +/- 5 to 18 +/- 5% (P < 0.05) in the high-flux polysulphone group, whereas these variables remained unchanged in the control group. Low-density lipoprotein and total cholesterol as well as Kt/V, protein catabolic r ate, parathyroid hormone, albumin, and body weight did not change. No change in lipoprotein lipase activity was found. In a second study, th e effects of a single hemodialysis session with high-flux polysulphone and low-flux, cellulose-based membranes on lipid parameters and lipol ytic activity were compared in a crossover fashion, Treatment with bot h membranes resulted in a significant decrease in plasma triglyceride, VLDL triglyceride, and VLDL cholesterol. Lipoprotein lipase activity increased during hemodialysis. Changes in lipid parameters and lipolyt ic activity were identical during the two treatments. These data indic ate a favorable change in lipid parameters after the switch from low-f lux, cellulose-based to high-flux, polysulphone dialysis membranes tha t appeared not to be caused by an enhancement of lipoprotein lipase ac tivity. Changes are of similar magnitude as can be obtained with dieta ry and pharmacologic treatments.