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Hemodialysis‐induced acute pancreatitis secondary to kinked hemodialysis blood lines
Authors:Abtahi M  Uzan M  Souid M
Affiliation:Phramongkutlao Hospital. Bangkok, Thailand.
Abstract:Objective: Blood‐membrane interaction during hemodialysis may contribute to inflammatory process, which accelerates the development of atherosclerosis in maintenance hemodialysis patients (MHD). Vitamin E has been widely used against oxidative stress in MHD. One of the strategies for the utilization of vitamin E in MHD patients is the usage of vitamin E‐coated membrane dialyzer. We investigated the effects of vitamin E‐coated membrane dialyzer on serum C‐reactive protein and interleukin‐6, the biomarker of inflammation, compared to polysulfone membrane dialyzer. Methods: Vitamin E‐coated membrane dialyzer (1.5‐m2 surface area) and synthetic polysulfone dialyzer (1.5‐m2 surface area) were manipulated in a crossover clinical study for 24 weeks in 10 non‐diabetic MHD patients. Run‐in and wash‐out periods (Cellulose tri‐acetate) were performed for 4 weeks before the treatment. Pre‐ and post‐dialysis blood samples were taken at the begining and the end of each dialyzer period (12 weeks). High‐sensitivity C‐reactive protein (hs‐CRP) and interleukin‐6 (IL‐6) were examined. Results: Mean age of the patients was 54.9 years old. CRP and IL‐6 levels were similarly increased after dialysis in both groups (4.8 ± 0.7 and 37.2 ± 9.4, respectively). The CRP and IL‐6 level in vitamin E‐coated membrane dialyzer treatment were lower than in polysulfone treatment (5.0 ± 1.2, p < 0.008 and 67.2 ± 12.4, p < 0.04, respectively). Serum albumin, hemoglobin level, and white blood cell count were not affected by types of dialyzer membrane. Conclusions: In our study, hemodialysis stimulated the inflammation as the previous study. Vitamin E‐coated membrane dialyzer may diminish the inflammatory process in MHD patients and may also prevent further atherosclerosis.
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