Renal Failure Clinical Trial
Official title:
The Effect of Vitamin E-coated Polysulfone Membrane on Oxidative Stress, Inflammation and Monocytes in Critically Ill Patients in CRRT: a Pilot, Randomized, Double-blinded, No-profit, Clinical Study
The study evaluate the effect of a membrane in polysulfone covered with vitamin E (ViE15-A,
ASAHI Kasey, Tokyo, Japan) versus non-vitamin E polysulfone membrane (REXEED-15A, ASAHI
Kasey, Tokyo, Japan) in critically ill patients admitted to intensive care undergoing
continuous extracorporeal dialysis (CRRT).
The current randomized study is designed to assess the effect on the levels of oxidative
stress, pro and anti-inflammatory cytokines and the mode and amount of death of monocytic
cell lines using ViE 15-A in comparison withe REXEED-15A.
The investigators hypothezise that the ViE15-A versus REXEED-15A will have different effect
on the levels of oxidative stress, pro and anti-inflammatory cytokines and the mode and
amount of death of monocytic cell lines.
The study evaluate the effect of a membrane in polysulfone covered with vitamin E (ViE15-A,
ASAHI Kasey, Tokyo, Japan) on the levels of oxidative stress, pro and anti-inflammatory
cytokines and the mode and amount of death of monocytic cell lines in critically ill patients
admitted to intensive care undergoing continuous extracorporeal dialysis (CRRT).
This membrane will be compared with a non-vitamin E polysulfone membrane (REXEED-15A, ASAHI
Kasey, Tokyo, Japan) and already intended for use in continuous renal support therapy.
The current randomized study is designed to assess the effect on the levels of oxidative
stress, pro and anti-inflammatory cytokines and the mode and amount of death of monocytic
cell lines using ViE 15-A in comparison withe REXEED-15A.
Precisely, will be evaluated
1. the effect of the filter on the reduction of the plasma levels of two pro-inflammatory
cytokines (IL-1β and IL-6) and of two anti-inflammatory cytokines (IL-10, IL-8);
2. the analysis of the life modality of the monocytic cells: the patient's plasma will be
used, incubated for 24 hours with U937 cells (monocyte precursor cells), necrosis cells
and the percentage of apoptotic cells. The apoptotic cells will also evaluate the
apoptotic pathway (evaluation of activated caspases) that led to cell death. The
differences that are highlighted in the two different sampling moments become expressed
Δ% with respect to the initial value Secondary outcomes will be to evaluate the clinical
outcomes (haemodynamic and hematochemical parameters) in the short and long term
deriving from the application of a membrane with vitamin E; for this reason, for the
whole duration of the extracorporeal dialysis therapy, the same filter assigned to the
patient at the time of enrollment will be used.
All the other parameters of the extracorporeal treatment that can influence the results will
be standardized; in particular, the flows will be fixed according to the dialysis dose
criteria and re-infusion methods according to the table in the paragraph "treatment
characteristics".
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