Method of treating a subject suffering from end stage renal disease against cardiovascular disease
The present invention relates to high cut-off hemodialysis membranes for the treatment of chronic hemodialysis (CHD) patients, with the potential to improve long-term survival of these patients by reducing the risk of cardiovascular disease, through down-regulation of monocyte activation in the blood. Monocytes are the major circulating blood cells involved in the progression of cardiovascular disease. High cut-off hemodialysis in chronic dialysis patients results in a sustained decrease in expression of monocyte cell-surface proteins that direct the movement of these cells from the blood to the walls of blood vessels, where they promote the progression of arterial disease (atherosclerosis) that leads to cardiovascular disease (CVD); heart disease, strokes and peripheral vascular disease.
1. A method of treating a subject suffering from end stage renal disease against cardiovascular disease, the method comprising hemodialyzing, hemofiltering or hemodiafiltering the blood of the subject using a dialysis membrane that permits passage of molecules having a molecular weight of up to 45 kD in the presence of whole blood to reduce the activation of monocytes in the blood of the subject.
2. The method of claim 1 , wherein the reduction of monocyte activation is indicated by the down-regulation of the expression of monocyte cell surface proteins.
3. The method of claim 2 , wherein the monocyte cell surface proteins are selected from the group consisting of PSGL-1 (CD162), CCR2, CX3CR1, and CD11b.
4. The method of claim 1 , wherein the reduction of monocyte activation is indicated by the reduction of pre-dialysis concentrations of circulating pro-inflammatory cytokines.
5. The method of claim 1 , wherein at least one hydrophilic polymer and at least one hydrophobic polymer are present in the dialysis membrane as domains on the surface of the dialysis membrane.
6. The method of claim 1 , wherein the dialysis membrane is a hollow fiber membrane and has at least a 3-layer asymmetric structure with a separation layer present in the innermost layer of the hollow fiber membrane.
7. The method of claim 6 , wherein the membrane has pores in the separation layer, said pores having a diameter in the range of 15 to 60 nm.
8. The method of claim 7 , wherein the pores have a diameter in the range of 20 to 40 nm.