A pilot, randomized, double-blind, cross-over study of high cut-off versus high-flux dialysis membranes.
BACKGROUND
High cut-off (HCO) membranes may increase beta(2)-microglobulin (beta2M) removal compared to standard high-flux membranes.


METHODS
Eight stable haemodialysis patients were enrolled in a prospective, randomized, double-blind, cross-over study and treated with HCO and high-flux membranes for 2 weeks each, between a 1-week washout period. Primary end point was serum beta2M removal. Secondary end points included serum albumin concentrations, albumin and small solute clearances.


RESULTS
HCO membranes achieved significantly lower median post-dialysis beta2M concentration (10.8 vs. 14.2 mg/l; p = 0.003) and greater beta2M reduction ratio (62.3 vs. 51.0%; p < 0.002). Serum albumin decreased with HCO membranes (from 36 to 29.5 g/l; p = 0.018) but increased to 33.5 g/l after the washout period. Albumin clearance was significantly greater with HCO membranes (2.2 vs. 0.06 ml/min; p = 0.004). Urea reduction ratio was significantly lower with HCO membranes (64.8 vs. 71.5%; p < 0.001).


CONCLUSIONS
beta2M removal was superior with HCO membranes. Reduction in serum albumin and lower small solute clearance require further investigations.
Lee
Darren
D
Department of Nephrology, Austin Hospital, University of Melbourne, Melbourne, Vic., Australia.
Haase
Michael
M
Haase-Fielitz
Anja
A
Paizis
Kathy
K
Goehl
Hermann
H
Bellomo
Rinaldo
R
D000368:Aged; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008422:Materials Testing; D008567:Membranes, Artificial; D008875:Middle Aged; D006435:Renal Dialysis / Q000295:instrumentation*; D012709:Serum Albumin / Q000032:analysis*; D016896:Treatment Outcome; D001613:beta 2-Microglobulin / Q000097:blood*
D008567:Membranes, Artificial; D012709:Serum Albumin; D001613:beta 2-Microglobulin