Impact of medium cut-off membranes on S100A12 and soluble receptor for advanced glycation end products

Seminars in dialysis(2023)

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摘要
Introduction Of the most remarkable molecules associated with atherosclerosis and the cardiovascular outcome are S100A12 (10,379.5 Da) and soluble receptor for advanced glycation end products (sRAGE-42,803 Da) in the hemodialysis (HD) population. We designed a study investigating the effects of the medium cut-off (MCO) dialyzers focusing on S100A12 and sRAGE in HD patients compared with low-flux and high-flux dialyzers. Methods This single-site, prospective, observational study comprises age and sex-matched HD groups (low-flux, high-flux, and MCO). Blood samples were drawn at baseline (predialysis and postdialysis) and the sixth month (predialysis). Results Groups had similar demographic features and laboratory parameters. Baseline S100A12 levels of the groups were similar [34.3 (+/- 66.5), 30.9 (+/- 42.7), and 40.6 (+/- 29.6); p = 0.13]. Compared to their baseline, the sixth-month S100A12 levels were constant in low-flux and high-flux group and significantly lower in MCO group (p = 0.16, p = 0.33, and p = 0.004). Baseline sRAGE levels of the groups were similar at baseline [2.8 (+/- 0.8), 2.7 (+/- 0.6), and 2.6 (+/- 0.7); p = 0.65], and the sixth-month [2.9 (+/- 0.5), 2.4 (+/- 0.7), and 2.4 (+/- 0.8); p = 0.24]. sRAGE levels remained constant in all groups [p = 0.84, p = 0.13, and p = 0.39]. S100A12/sRAGE ratio at baseline and sixth month was constant in low-flux [22.3 (+/- 63.7) and 18.1 (+/- 24.8); p = 0.17] and high-flux groups [11.9 (+/- 15.3) and 13.1 (+/- 5.8); p = 0.26], the ratio decreased significantly in MCO group [16.5 (+/- 11.6) to 7.8 (+/- 5.5); p = 0.03]. Conclusion Our study suggests that prolonged use of MCO dialyzers is associated with better S100A12 and sRAGE levels. Long-term studies with larger samples are needed to understand the effects of a better S100A12-sRAGE profile provided by MCO dialyzers on HD patients' cardiovascular outcomes.
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