Effects of vitamin E-coated dialysis membranes on anemia, nutrition and dyslipidemia status in hemodialysis patients: a meta-analysis

Ren Fail. 2015 Apr;37(3):398-407. doi: 10.3109/0886022X.2014.1001281. Epub 2015 Jan 14.

Abstract

Background: This was controversial whether vitamin E-coated dialyzer therapy was beneficial for the complications associated with hemodialysis. Therefore, we performed this systematic review to evaluate the effects of vitamin E-coated dialyzer.

Methods: Related trials were searched from multiple electronic databases. We conducted meta-analysis to assess changes in the predefined outcomes using RevMan 5.3 software.

Results: Meta-analysis showed vitamin E-coated dialyzer therapy could decrease erythropoietin (EPO) resistance index (SMD, -0.24; 95% CI, -0.47 to -0.01; p = 0.04). However, pooled-analysis showed vitamin E-coated dialyzer therapy could not decrease weekly EPO dose (SMD, -0.11; 95% CI, -0.32 to 0.09; p = 0.28) and intima-media thickness (IMT) of the carotid artery (MD, -0.09; 95% CI, -0.2 to 0.01; p = 0.09), and vitamin E-coated dialyzer therapy did not improve the serum hemoglobin (MD, -0.03; 95% CI, -0.18 to 0.13; p = 0.74), albumin levels (SMD, -0.64; 95% CI, -1.62 to 0.34; p = 0.2), in addition, there was no significant difference in serum cholesterol (SMD, -0.07; 95% CI, -0.45 to 0.31; p = 0.71), triglycerides (MD, -2.77; 95% CI, -32.42 to 26.87; p = 0.85), high density lipoprotein (HDL) (SMD, 0.24; 95% CI, -0.14 to 0.62; p = 0.22) and low density lipoprotein (LDL) (SMD, 0.00; 95% CI, -0.38 to 0.37; p = 0.98) levels.

Conclusions: Vitamin E-coated dialyzer may reduce the EPO resistance, but there is no conclusive evidence that vitamin E-coated dialyzer can improve the renal anemia, malnutrition, dyslipidemia and atherosclerosis status in hemodialysis (HD) patients. However, high-quality trials with hard clinical endpoints are required to fully elucidate the clinical value of vitamin E-coated dialyzer therapy.

Keywords: Dialyzer; hemodialysis; meta-analysis; vitamin E.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Anemia* / diagnosis
  • Anemia* / etiology
  • Antioxidants / pharmacology
  • Coated Materials, Biocompatible / pharmacology
  • Dyslipidemias* / diagnosis
  • Dyslipidemias* / etiology
  • Humans
  • Kidney Failure, Chronic / therapy*
  • Membranes, Artificial*
  • Nutritional Status / drug effects*
  • Outcome Assessment, Health Care
  • Randomized Controlled Trials as Topic
  • Renal Dialysis* / adverse effects
  • Renal Dialysis* / instrumentation
  • Renal Dialysis* / methods
  • Vitamin E / pharmacology*

Substances

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