[Comparison of the iron metabolism and effectiveness of anemia treatment in patients on maintenance hemodialysis performed based on polysulfone and helixone dialyzers].

INTRODUCTION Anemia is a common complication in patients with chronic renal failure (CRF) especially on maintenance hemodialysis. There are some data that the use of biocompatible high-flux dialyzers is more efficient than low-flux dialyzers in controlling some uremia related diseases including anemia. The aim of the study was to assess the iron metabolism and degree of anemia correction in patients on maintenance hemodialysis performed based on low-flux dialyzers (HD-LF), with polysulfone membrane and high- flux dialyzers (HD-HF), with helixone membrane. MATERIAL AND METHODS The observation lasted 12 months and involved 60 patients (23 F and 37 M) aged from 24 to 84 years, mean 60.73 ± 15.75 treated on maintenance HD. RESULTS It was demonstrated a higher mean Hb and Ht values during period of HD-HF as compared with the HD-LF (LF-Hb = 11.09 ± 0.89 vs. HF-Hb = 11.42 ± 0.98; p < 0.01 and LF- Ht = 33.7 ± 2.87% vs. HF-Ht = 34.45 ± 3.08%). Higher values of Hb and Ht during HD-HF were obtained at a comparable average doses of darbepoetin alfa (Aranesp) used in both periods (LF-Aranesp = 8.29 ± 4.17 μg vs. HF-Aranesp = 8.25 ± 3.92 μg; p ≤ 0.29) and statistically significantly lower average doses of intravenous iron administered during HD-HF (LF-iron iv = 17.59 ± 10.44 mg vs. HF-iron iv 12.16 ± 9.04 mg; p < 0.01). It was also shown a statistically significant higher mean corpuscular volume of red blood cells (MCV) in patients during HD-HF (LF-MCV = 91.15 ± 6.6 μm3 vs. HF- MCV = 95.03 ± 5.38 μm3; p ≤ 0.001) and lower mean ferritin values (LF-ferritin = 636.33 ± 704.57 ng/ml vs. HF-ferritin = 538 ± 475.92 ng/ml; p ≤ 0.001). CONCLUSIONS Lower intravenous iron use during HD-HF, with higher Hb values in these period may indicate on may indicate an increased loss of folates during HD-HF and the necessity of its increased supplementation.