Version 1
: Received: 13 August 2024 / Approved: 14 August 2024 / Online: 16 August 2024 (03:38:33 CEST)
How to cite:
Rodríguez-Espinosa, D.; Cuadrado-Payán, E.; Morantes, L.; Gomez, M.; Maduell, F.; Broseta, J. J. Lipid and Immunophenotypic Profiles in Hemodialysis Patients with Citrate vs. Acetate Dialysates. Preprints2024, 2024081077. https://doi.org/10.20944/preprints202408.1077.v1
Rodríguez-Espinosa, D.; Cuadrado-Payán, E.; Morantes, L.; Gomez, M.; Maduell, F.; Broseta, J. J. Lipid and Immunophenotypic Profiles in Hemodialysis Patients with Citrate vs. Acetate Dialysates. Preprints 2024, 2024081077. https://doi.org/10.20944/preprints202408.1077.v1
Rodríguez-Espinosa, D.; Cuadrado-Payán, E.; Morantes, L.; Gomez, M.; Maduell, F.; Broseta, J. J. Lipid and Immunophenotypic Profiles in Hemodialysis Patients with Citrate vs. Acetate Dialysates. Preprints2024, 2024081077. https://doi.org/10.20944/preprints202408.1077.v1
APA Style
Rodríguez-Espinosa, D., Cuadrado-Payán, E., Morantes, L., Gomez, M., Maduell, F., & Broseta, J. J. (2024). Lipid and Immunophenotypic Profiles in Hemodialysis Patients with Citrate vs. Acetate Dialysates. Preprints. https://doi.org/10.20944/preprints202408.1077.v1
Chicago/Turabian Style
Rodríguez-Espinosa, D., Francisco Maduell and José Jesús Broseta. 2024 "Lipid and Immunophenotypic Profiles in Hemodialysis Patients with Citrate vs. Acetate Dialysates" Preprints. https://doi.org/10.20944/preprints202408.1077.v1
Abstract
Background: Chronic kidney disease (CKD) is a significant cardiovascular (CV) risk factor, with dialysis-dependent CKD (DD-CKD) patients facing high mortality rates. Hypercholesterolemia is another crucial CV risk factor, typically managed with lipid-lowering therapy, though its efficacy in DD-CKD remains uncertain. Evidence shows mixed results regarding the benefits of statins in these patients. Citrate-based dialysates are known to reduce inflammatory biomarkers compared to acetate-based ones, potentially impacting lipid profiles and immune responses. This study aimed to determine the effects of citrate versus acetate dialysate on lipid profiles and immunophenotypes in DD-CKD patients. Methods: This unicentric, cross-over, prospective study included 21 hemodialysis patients (10 males, 11 females, average age 62.25 years). Each patient underwent 24 dialysis sessions (12 with each dialysate) and acted as their own control. Lipid profiles, immunological parameters, and nutritional and inflammatory markers were measured before the last session with each dialysate. Results: Compared to acetate dialysate (AD), citrate dialysate (CD) resulted in significantly higher LDL (75.71 vs. 67.05 mg/dL, p=0.042) and HDL (51.19 vs. 47.14 mg/dL, p=0.013), and lower TG (97.86 vs. 110.38 mg/dL, p=0.046). CD also led to higher NK cells (19.24 vs. 16.95%, p=0.035), higher complement C3 levels (115.14 vs. 107.81 mg/dL, p=0.009) and lower CD3+ CD8+ and CD16+56+ lymphocytes. Finally, total lymphocytes were lower with AD than with CD. We found no difference in predialysis nutritional nor inflammatory parameters (IL-6 and hs-CRP) except for ESR, which was higher when subjects used CD than AD. Conclusion: There are significant differences in lipid and immunophenotypic profiles that should increase the CV risk of patients who use CD. However, numerous studies have shown no differences, or even a benefit in mortality in certain HD subpopulations that use CD. Further studies are needed to understand if the observed changes may be counterbalanced by other mechanisms potentially provided by citrate (e.g., reducing vascular calcification).
Copyright:
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