Abstract
BACKGROUND
Oxidative stress resulting from membranes is dependent on the increase in production of toxic‐free oxygen radicals occurring through the mediation of complement and leukocyte activation. Increased oxidative stress causes morbid results such as erythropoietin resistance, accelerated aging, and atherosclerosis. This study aimed to determine the stress potentials of 2 distinct synthetic membranes different than used in previous studies. In our study, the effects of using polysulfone (PSU) and ethylene vinyl alcohol (EVAL) for 3‐month periods in the same patient group on malondialdehyde (MDA) levels, biomarker for oxidative stress, and proinflammatory cytokine production were compared.
METHODS
PSU and EVAL membranes with the same surface area were used in 21 chronic hemodialysis patients (12 men and 9 women, mean age 66.66 ± 12.47 years) during successive 3‐month periods. Treatments and dialysate contents administered during this period were not changed. At the end of each period, interleukin (IL)‐1, IL‐6, tumor necrosis factor a (TNF‐α), and MDA levels in patients' sera were determined before dialysis, and the data obtained from the study were compared using the paired‐sample t test.
RESULTS
A significant decrease in C‐reactive protein levels was seen after EVAL usage compared with PSU usage (p < 0.05). Although an increase was seen in hemoglobin levels, it was not considered statistically significant. It was determined that there was not a statistically significant difference in the change in TNF‐α, IL‐1, and IL‐6 levels (0.002 ± 0.0009 ng/mL, 1.33 ± 0.84 ng/mL, and 0.05 ± 0.05 ng/mL, respectively) measured after PSU usage with that in the TNF‐α, IL‐1, and IL‐6 levels (0.003 ± 0.001 ng/mL, 1.44 ± 1.37 ng/mL, and 0.05 ± 0.05 ng/mL, respectively) measured after EVAL usage (p > 0.05). MDA levels were determined to be 15.08 ± 5.28 mM after PSU usage and 5.96 ± 2.24 mM after EVAL usage. Lower MDA levels obtained after EVAL usage were considered to be highly statistically significant (p = 0.001).
CONCLUSIONS
Studies and searches are continuing toward determining and controlling oxidative stress potentials of dialysates used in addition to determining their high efficacy. This study, which investigated oxidative stress levels produced by 2 synthetic membranes in the same patient group, demonstrated that widely used PSU membranes cause more oxidative stress than EVAL membranes. Studies to decrease oxidative stress potentials of PSU membranes that have high diffusion and convection ability and also high‐flow forms in production compared with EVAL membranes are focusing on vitamin E–coated forms.