Clinical evaluation of the efficacy of a vitamin E-coated membrane hemodiafilter (V-22RA) in hemodialysis patients: a single-center prospective interventional study

Background Hemodialysis (HD) patients exhibit elevated oxidative stress (OS). In these patients, vitamin E-coated membranes decrease OS, with reported clinical benefits including reductions in inflammatory markers and improvements in anemia. Here, we evaluated the efficacy of a newly developed vitamin E-coated membrane hemodiafilter, v-era ® V-RA. Methods This single-center, single-arm, prospective interventional study enrolled 12 patients (median [interquartile range (IQR)] age: 62.5 [52.8–71.0] years; median [IQR] dialysis vintage: 6.5 [4.2–8.8] years). All patients were undergoing postdilution online hemodiafiltration (post-OHDF) three times weekly for 4 h per session using the FIX-210Seco (an Asymmetric Triacetate Membrane ® hemodiafilter). Patients were then switched from post-OHDF with FIX-210Seco to post-OHDF with V-22RA. Baseline data immediately prior to switching were compared with data obtained after patients were switched to V-22RA. Results No significant difference in removal efficiency was observed between before and after switching to V-22RA. Oxidized low-density lipoprotein (ox-LDL) significantly increased from 77.5 [74.0–93.5] to 89.5 [76.8–114.8] U/L with FIX-210Seco ( p = 0.041). In contrast, with V-22RA, ox-LDL nonsignificantly decreased from 73.0 [58.0–81.0] to 67.5 [59.7–102.5] U/L ( p = 0.084). The verbal rating scale score for postdialysis fatigue significantly decreased at 2 months, from 1.0 [1.0–2.0] to 0 [0–0.3] ( p = 0.003). Similarly, dialysis recovery time was significantly shortened at 2 months, from 2.0 [1.0–2.3] to 0 [0–0.6] h ( p = 0.004). At 6 months, ox-LDL levels significantly decreased from 77.5 [58.0–81.0] to 60.5 [50.3–68.5] U/L ( p < 0.001). Conclusions Post-OHDF use of V-22RA may contribute to the improvement of postdialysis fatigue and dialysis recovery time by reducing ox-LDL and alleviating OS.