Effects of Vitamin E-Coated versus Conventional Membranes in Chronic Hemodialysis Patients: A Systematic Review and Meta-Analysis

Blood Purif. 2017;43(1-3):101-122. doi: 10.1159/000453444. Epub 2016 Dec 14.

Abstract

Introduction: Accruing evidence suggests that vitamin E-coated membranes (ViE-m) might improve the clinical management of chronic hemodialysis (HD) patients.

Methods: We conducted a systematic review and meta-analysis of RCTs comparing ViE-m to conventional HD. Endpoints of interest were a series of biomarkers pertaining to anemia status, inflammation, oxidative stress and dialysis efficacy/status.

Results: Sixty studies were included. ViE-m significantly improved the Erythropoietin Resistance Index but had no impact on other anemia parameters. As for oxidative stress and inflammation, ViE-m produced a significant decrease in interleukin-6 levels, thiobarbituric acid reactive substances, plasma and red blood cell (RBC) malonylaldehyde and a significant increase in blood and RBC vitamin E. Conversely, ViE-m use had no impact on lipid profile, dialysis adequacy, blood pressure, albumin and uric acid.

Conclusions: ViE-m might ameliorate anemia management by reducing oxidative stress and inflammation. Benefits of these bio-membranes on harder clinical outcomes are uncertain and need to be investigated by future, targeted trials.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Anemia / prevention & control
  • Coated Materials, Biocompatible / standards*
  • Humans
  • Inflammation / prevention & control
  • Kidney Failure, Chronic / therapy
  • Membranes, Artificial*
  • Oxidative Stress / drug effects
  • Renal Dialysis / adverse effects
  • Renal Dialysis / instrumentation*
  • Vitamin E / pharmacology*

Substances

  • Coated Materials, Biocompatible
  • Membranes, Artificial
  • Vitamin E