End Stage Renal Disease, Inflammation
Conditions
Brief summary
Evaluation of the effect of a vitamin E coated high flux polysulfone dialyzer on the inflammatory state of patients' end stage renal disease and its clinical benefits in terms of anemia Objectives : To assess the benefits of a vitamin E coated polysulfone membrane on the micro-inflammatory state of chronic dialysis patients Prospective multicenter controlled and randomized study Number of patients : 120 patients (60 patients per group)
Detailed description
Coordinator : Pr JP.CRISTOL Montpellier hospital university Rational : The hemodialyzed patients are subject to inflammation due to their pathologies and to the technique. The VIE dialyzer polysulfon coated to vitamin E has been shown to have a favourable action on inflammation and anemia. The investigators want to highlight the influence of vitamine E graft using as controlled dialyzer a similar polysulfon from the same manufacturer without vitamin E. Medical device : ViE High flux dialyzer -\> vitamin E coated polysulfone membrane manufactured by Asahi Kasei Medical, with CE mark and intended for use in hemodialysis for the patient suffering from acute or chronic renal failure Controlled medical device : Leoceed H high flux dialyzer : polysulfone membrane manufactured by Asahi Kasei Medical, with CE mark and intended for use in hemodialysis for patient suffering from acute or chronic renal failure Objectives : To assess the benefits of a vitamin E coated polysulfone membrane on the micro-inflammatory state of chronic dialysis patients Primary end point : Evolution of the well-known inflammatory marker : High sensibility-CRP Secondary end point : Evolution of the following inflammatory markers : IL-6, TNFa, fibrinogen, antibodies anti- LDLox Evolution of Hemoglobin and ERI Evolution of Nutritional parameters : albumin and pre albumin Study design : Prospective multicenter controlled and randomized protocol study Duration : 12 months Number of patients : 120 patients : 60 patients per group 120 patients : 60 patients per group Adult ESRD patient, whatever the origin, treated by HD, thrice a week for about 4 hours and hemo dynamically well balanced Inclusion criteria : Dialyzed patient on synthetic high flux dialyzer for 3 months Patient with a vascular access allowing a blood flow rate ≥ 250 ml/min Patient with micro inflammation, i.e an average CRP between 5 and 20 mg/L on the two last check-up of CRP Patient informed of the study and having signed the inform consent. Exclusion criteria : Underage patient Subjects who are pregnant or planning to become pregnant during the study Patient with an infection influencing the Hb level Patient with an Iron deficiency showed with : Transferin saturation \< 20 % and/or Ferritin \< 100 µg/L, Hemo transfusion in the last two months Patient treated by HF, HDF, biofiltration Patient with infectious risks Subjects who participated in a clinical study involving dialyzers in the last two months Criteria of exit : Patient wish Medical decision Hemo transfusion Departure for another dialysis center Transplantation Death
Interventions
Asssesment of the therapeutic effect of the vitamin E coating
Use of the Leoceed H dialyzer during one year per patient enrolled in the control group
Sponsors
Study design
Intervention model description
Prospective multicenter controlled and randomized protocol study
Eligibility
Inclusion criteria
* Adult ESRD patient, whatever the origin, treated by HD, thrice a week for about 4 hours and hemo dynamically well balanced * Dialyzed patient on synthetic high flux dialyzer for 3 months * Patient with a vascular access allowing a blood flow rate ≥ 250 ml/min * Patient with micro inflammation, i.e an average CRP between 5 and 20 mg/L on the two last check-up of CRP * Patient informed of the study and having signed the inform consent.
Exclusion criteria
* Underage patient * Subjects who are pregnant or planning to become pregnant during the study * Patient with an infection influencing the Hb level * Patient with an Iron deficiency showed with : Transferin saturation \< 20 % and/or Ferritin \< 100 µg/L, * Patients having received an Hemo transfusion in the last two months * Patient treated by HF, HDF, biofiltration * Patient with infectious risks * Subjects who participated in a clinical study involving dialyzers in the last two months
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Evolution of the well-known inflammatory marker : High sensibility-CRP | one year with a follow-up of three months | Decrease of the CRP marker due the use of vitamin E coated dialyzer |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Inflammatory markers | one year with a follow-up of three months | Evolution of the following inflammatory markers : IL-6, TNFalpha, fibrinogen, antibodies anti-LDLox |
| Anemia parameters | one year with a follow-up of three months | Evolution of Hemoglobin and ERI |
| Nutritional Parameters | one year with a follow-up of three months | Albumin and pre-albumin parameters |
Countries
France