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Updated: Sep 15, 2026

Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Do different dialytic techniques have different atherosclerotic and antioxidant activities?
S Biasioli1, R Schiavon, L Petrosino
1Nephrology and Dialysis Unit, Legnano Hospital, Italy.
Insights
Paired filtration dialysis (PFD) shows the best acute results in improving atherosclerosis and antioxidant activity in chronic hemodialysis patients. PFD effectively normalized atherosclerotic and antioxidant indices after a single session, unlike other dialytic techniques.
Area of Science:
- Nephrology
- Biochemistry
- Cardiovascular Medicine
Background:
- Chronic hemodialysis (HD) patients exhibit altered atherosclerosis and antioxidant status.
- Dialytic techniques may differentially impact these metabolic parameters.
Purpose of the Study:
- To compare the chronic effects of bicarbonate dialysis (BHD), acetate-free biofiltration (AFB), hemodiafiltration (HDF), and paired filtration dialysis (PFD) on atherosclerosis and antioxidant activity.
- To evaluate the efficacy of different dialytic techniques in normalizing key biochemical indices.
Main Methods:
- Development of an atherosclerotic index (AI) and an antioxidant activity index (AOAI) using plasma and erythrocyte parameters.
- Calculation of a defense index (DI) as AOAI - AI.
- Measurement of indices in 20 controls and 51 chronic HD patients undergoing BHD, AFB, HDF, or PFD for at least 12 months, before, during, and after a dialysis session.
Main Results:
- HD patients showed significantly higher AI and lower AOAI compared to controls.
- Paired filtration dialysis (PFD) demonstrated the most favorable acute results, with indices approaching normal values post-session.
- Other techniques like BHD, AFB, and HDF showed less pronounced improvements in AI and AOAI.
Conclusions:
- Paired filtration dialysis (PFD) appears to be the most effective dialytic technique for acutely improving markers of atherosclerosis and antioxidant activity in chronic hemodialysis patients.
- The developed indices (AI, AOAI, DI) provide a quantitative measure to assess the impact of different dialytic strategies on oxidative stress and atherogenesis.
Abstract:
To compare the chronic effect of several dialytic techniques (bicarbonate dialysis, BHD; acetate free biofiltration, AFB; hemodiafiltration, HDF; paired filtration dialysis, PFD) on atherosclerosis and antioxidant activity, three different indices were created. The first (atherosclerotic index = AI) is formed using the sum of three plasma substances: MDA, Hcy, and Cys (malondialdehyde, homocysteine, cysteine). The second (antioxidant activity index = AOAI) is the sum of five erythrocyte (E) parameters: E-GSH, GPx, CAT, SOD, GR (E-glutathione, E-glutathione peroxidase, E-catalase, E-superoxide dismutase, E-glutathione reductase). The third (defense index = DI) is derived from the previous two: (AOAI - AI). The indices were so expressed as AI in mmol/L, AOAI in U/g hemoglobin (Hb), and DI in arbitrary units. These indices were calculated in 20 controls and 51 chronic HD patients (26 female, 25 male) before, during, and after the first session of the week. HD patients were divided according to their dialytic technique: BHD, n = 35; AFB, n = 5 patients; HDF, n = 7 patients; or PFD = 4 patients. All patients had been treated with a given technique for at least 12 months, before entering the study. As expected, HD patients had AI values higher than controls, both before and after the session, with a mean value of 541 (before) and 331 (after), whereas controls had a mean value of 205. The AOAI was lower than controls, both before and after the session, the mean value being 1,122 (before) and 1,582 (after), that of controls being 2,424. In all cases, PFD gave the best "acute" results; at the end of a PFD session, near normal values of AI, AOAI, and DI (defensive index = AOAI - AI) were obtained.
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