Unique ID issued by UMIN | UMIN000033778 |
---|---|
Receipt number | R000038466 |
Scientific Title | Effect of hemoperfusion with hexadecyl-immobilized cellulose beads on myocardial fatty acid imaging in hemodialysis patients: a case series study |
Date of disclosure of the study information | 2018/09/01 |
Last modified on | 2019/02/04 21:33:02 |
Effect of hemoperfusion with hexadecyl-immobilized cellulose beads on myocardial fatty acid imaging in hemodialysis patients: a case series study
Effect of hemoperfusion with hexadecyl-immobilized cellulose beads on myocardial fatty acid imaging in hemodialysis patients
Effect of hemoperfusion with hexadecyl-immobilized cellulose beads on myocardial fatty acid imaging in hemodialysis patients: a case series study
Effect of hemoperfusion with hexadecyl-immobilized cellulose beads on myocardial fatty acid imaging in hemodialysis patients
Japan |
Chronic kidney disease
Nephrology |
Others
NO
Hexadecyl immobilized in porous cellulose beads (HICBs) with an appropriate pore size and a mean diameter of 460 mm in a column (Lixelle; Kaneka Medix Co) were originally designed to selectively adsorb beta 2-microglobulin (B2-MG) through hydrophobic interactions. Several reports suggested that the Lixelle column removes not only B2-MG but also several inflammatory cytokines and free protein-binding uremic toxins (PBUTs). Dialysis patients are in a chronic activated inflammatory state as demonstrated by both elevated inflammation markers and proinflammatory cytokines, such as Interleukin-6 (IL-6). Recently, the levels of IL-6 have been found to have a strong correlation with both total and cardiovascular mortality in hemodialysis patients. Furthermore, PBUTs also accumulate in hemodialysis patients, and high circulating levels of these toxins were reported to be associated with chronic kidney disease-related complications, including cardiovascular disease.
Cardiac deaths account for the high mortality of hemodialysis patients. We have shown that impaired myocardial fatty acid metabolism assessed by single-photon emission computed tomography (SPECT) using 123I-B-methyliodophenyl pentadecanoic acid (BMIPP) is likely to be associated with cardiac death in hemodialysis patients. This predictive potential of BMIPP SPECT for cardiac death in hemodialysis patients was identified in a multicenter cohort study in Japan. The purpose of this retrospective study is to clarify whether direct hemoperfusion with HICBs improves the impaired myocardial fatty acid imaging in hemodialysis patients.
Efficacy
Exploratory
Pragmatic
Hemodialysis patients who had been treated with HICB columns for more than 4 years are assigned to the HICBs group, while the other patients were assigned to the non-HICBs group.
All patients taked two BMIPP SPECTs at intervals of more than 3 years. The images were divided into 17 segments for semiquantitative analysis according to the standard myocardial segmentation for tomographic heart imaging established by the American Heart Association. The amount of radioactivity taken up by each segment was visually graded and assigned an uptake score of either 0 (normal), 1 (mildly reduced), 2 (moderately reduced), 3 (severely reduced), or 4 (none). The BMIPP SPECT scores for 17 myocardial segments were designated as the BMIPP summed score (SS). We compared first and second BMIPP SPECT SS in HICBs group and non-HICBs group.
Observational
50 | years-old | <= |
90 | years-old | > |
Male and Female
The eligibility criteria for enrollment in this study were as follows; (1) patients on dialysis for 10 years or more, (2) at least 3 years between the first and second BMIPP SPECT (Observation period). Among them, patients who treated HICB column for more than 4 years were assigned to HICBs group. Patients who had never been treated with HICBs column were assigned to non-HICBs group.
Patients who received percutaneous coronary intervention or coronary artery bypass grafting during the observation period.
30
1st name | |
Middle name | |
Last name | Naoki Suzuki |
Toujinkai Hospital
Clinical Engineering
83-1, Iga, Momoyama-cho, Fushimi-ku, Kyoto 612-8026, Japan
075-622-1991
suzuki@tojinkai.jp
1st name | |
Middle name | |
Last name | Naoki Suzuki |
Toujinkai Hospital
Clinical Engineering
83-1, Iga, Momoyama-cho, Fushimi-ku, Kyoto 612-8026, Japan
075-622-1991
suzuki@tojinkai.jp
Division of Clinical engineering, Toujinkai Hospital
Division of Clinical engineering, Toujinkai Hospital
Other
NO
2018 | Year | 09 | Month | 01 | Day |
Published
The HICBs group showed a lower mean B2-MG than that of the non-HICBs group, while other clinical baseline patient characteristics did not differ between the HICBs and the non-HICBs groups. In the HICB group, the 2nd BMIPP SS was significantly decreased compared to that for the 1st BMIPP SS. A decrease in the BMIPP SS was observed in 9 (75%) patients with 1st BMIPP SS >= 6, and no change was observed in 3 patients with BMIPP SS <= 2. In the non-HICBs group, the 2nd BMIPP SS was significantly increased compared to that for the 1st BMIPP SS.
Completed
2010 | Year | 04 | Month | 01 | Day |
2010 | Year | 04 | Month | 01 | Day |
2017 | Year | 12 | Month | 31 | Day |
2018 | Year | 08 | Month | 15 | Day |
2018 | Year | 08 | Month | 15 | Day |
2018 | Year | 08 | Month | 15 | Day |
Twenty-four hemodialysis patients in the Toujinkai group met the eligibility criteria between April 1st 2010 and December 31th 2017. Among them, 12 patients who had had been treated with HICB columns for more than 4 years were assigned to the HICBs group (mean observation period: 61.9 +- 16.3 months), while the other patients were assigned to the non-HICBs group (mean observation period: 58.0 +- 12.2 months).
2018 | Year | 08 | Month | 16 | Day |
2019 | Year | 02 | Month | 04 | Day |
Value
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000038466