title: Comparison of removal capacity of two consecutive generations of high-flux dialysers during different treatment modalities.
abstract: BACKGROUND
  Innovative modifications have been introduced in several types of dialyser membranes to improve adequacy and permselectivity. Which aspects of removal are modified and how this relates to different diffusive or convective strategies has, however, been insufficiently investigated.
  
  
  METHODS
  In a prospective cross-over study, 14 chronic kidney disease (Stage 5D) patients were dialysed with a second-generation high-flux dialyser (Polynephron) in comparison to a first-generation type (DIAPES-HF800). Both dialysers were assessed in haemodialysis, in online pre-dilution and in post-dilution haemodiafiltration. Reduction ratio (RR, %) of small water-soluble compounds (urea and uric acid), low-molecular weight proteins (LMWPs) (β(2)-microglobulin, cystatin C, myoglobin and retinol-binding protein) and protein-bound solutes (hippuric acid, indole acetic acid, indoxylsulphate and p-cresylsulphate) was assessed, together with albumin losses into the dialysate.
  
  
  RESULTS
  Comparing the two types of membranes, the second-generation dialyser demonstrated a higher RR for LMWPs, whilst at the same time exhibiting lower albumin losses but only during post-dilution haemodiafiltration. No differences in RR were detected for both the small water-soluble and the protein-bound compounds. Comparing dialysis strategies, convection removed the same amount of solute or more as compared to diffusion.
  
  
  CONCLUSIONS
  The second-generation membrane resulted in a higher removal of LMWPs compared to the first-generation membrane, but for the other solutes, differences were less prominent. Convection was superior in removal of a broad range of uraemic retention solutes especially with the first-generation membrane.
authors.affiliation: Renal Division, University Hospital Gent, Gent, Belgium. natalie.meert@ugent.be
authors.forename: Natalie
authors.initials: N
authors.lastname: Meert
authors.forename: Sunny
authors.initials: S
authors.lastname: Eloot
authors.forename: Eva
authors.initials: E
authors.lastname: Schepers
authors.forename: Horst-Dieter
authors.initials: HD
authors.lastname: Lemke
authors.forename: Annemieke
authors.initials: A
authors.lastname: Dhondt
authors.forename: Griet
authors.initials: G
authors.lastname: Glorieux
authors.forename: Maria
authors.initials: M
authors.lastname: Van Landschoot
authors.forename: Marie-Anne
authors.initials: MA
authors.lastname: Waterloos
authors.forename: Raymond
authors.initials: R
authors.lastname: Vanholder
mesh_terms: D000368:Aged; D018592:Cross-Over Studies; D015314:Dialysis Solutions; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D017583:Hemodiafiltration / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000628:therapy*; D007677:Kidney Function Tests; D008297:Male; D008567:Membranes, Artificial; D009862:Online Systems; D011446:Prospective Studies; D006435:Renal Dialysis / Q000295:instrumentation* / Q000379:methods; D015996:Survival Rate; D014118:Toxins, Biological; D016896:Treatment Outcome
chemical_list: D015314:Dialysis Solutions; D008567:Membranes, Artificial; D014118:Toxins, Biological