Elimination of middle-sized uremic solutes with high-flux and high-cut-off membranes: a randomized in vivo study.
The elimination of substances between 10 and 50 kDa by conventional high-flux membranes is not satisfactory. We investigated in vivo the elimination of middle-sized uremic solutes by conventional polyflux (PF) and modified high-cut-off (HCO) membranes. All 12 patients underwent four treatments, two with the HCO dialyzer and two with the PF dialyzer, each in either a haemodialysis (HD) or haemodiafiltration (HDF) mode. The reduction ratio of urea, creatinine, β2-microglobulin (β2M), leptin, soluble TNF-RI, complement factor D, IL-6, sIL-6 receptor, advanced glycation end-products (AGEs) and albumin was determined. In addition, the amount removed was determined in the dialysate for β2M, complement factor D, AGEs and albumin. Treatment with HCO removed β2M, sTNF-RI, factor D, and high molecular AGE significantly better than conventional high-flux membranes. The albumin loss was higher when using HCO membranes. HCO membranes are a promising approach to improve removal of uremic toxins not affected by conventional high-flux membranes.
Department of Nephrology and Intensive Care Medicine, Universitätsmedizin Berlin, Charité Campus Virchow Clinic, Berlin, Germany.
C
C
Kneis
W
W
Beck
O
O
Boenisch
F
F
Klefisch
R
R
Deppisch
D
D
Zickler
R
R
Schindler
D000328:Adult; D000368:Aged; D018592:Cross-Over Studies; D005260:Female; D017583:Hemodiafiltration / Q000295:instrumentation / Q000379:methods; D015312:Hemodialysis Solutions; D006801:Humans; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D016896:Treatment Outcome; D014511:Uremia / Q000097:blood* / Q000209:etiology / Q000628:therapy*
D015312:Hemodialysis Solutions; D008567:Membranes, Artificial