Vitamin E-coated dialyzer reduces oxidative stress in hemodialysis patients

The high incidence of cardiovascular disease in hemodialyzed (HD) patients is well established and oxidative stress has been involved in this phenomen on. The aim of our study was to evaluate if a vitamin E-coated dialyzer cou ld offer protection to HD patients against oxidative stress. Sixteen HD pat ients were successively assessed for one month (i) on a high biocompatible synthetic dialyzer (AN) and (ii) on a vitantin E-coated dialyzer (VE). Bloo d samples were taken before and after the dialysis session at the end of ea ch treatment period. HD session conducted with the AN dialyzer was responsi ble for acute oxidative stress, significantly assessed after HD by, a decre ased plasma vitamin C level and an increased ascorbyl free radical AFR/vita min C ratio used as an index of oxidative stress. Plasma elastase activity, reflecting neutrophil activation, was also increased; soluble P-selectin, reflecting platelet activation, did not show any variation. The use of the VE dialyzer was associated with a less extended oxidative stress compared w ith the AN membrane: basal vitamin C level was higher, and after the HD ses sion AFR/vitamin C ratio and elastase activity were not significantly incre ased. Plasma vitamin E levels were not affected. Our study demonstrates tha t HD is associated with oxidative stress, which can be partially prevented by the use of a vitamin E-coated dialyzer. Our data suggest that this dialy zer may exert a site-specific scavenging effect on free radical species in synergy with a reduced activation of neutrophils. (C) 2001 Elsevier Science Inc.