Effects of Medium Cut-Off Dialyzers on Fat Tissue and Muscle Mass Indices

IF 2.3 3区医学 Q3 ENGINEERING, BIOMEDICAL

Artificial organs Pub Date : 2025-03-13 DOI:10.1111/aor.14997

Yelda Deligoz Bildaci, Mert Esme, Berfu Korucu, Ege Erbay, Barkin Yigitbasi, Banu Dilek, Zekiye Selin Senturk, Caner Cavdar, Serpil Muge Deger

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引用次数: 0

Abstract

Background

Medium cut-off (MCO) dialyzers are designed to provide clearance of large–middle molecular weight uremic toxins and cytokines that are also responsible for the pathogenesis of sarcopenia.

Aim

To investigate the short- and long-term effects of MCO dialyzers on fat and muscle mass.

Methods

This single-center prospective, cross-over study includes 20 maintenance hemodialysis (MHD) patients treated with low-flux (LF) dialyzers. Baseline parameters were measured under LF dialyzers and repeated at 2nd week and 6th month after switching to MCO dialyzers. Fat tissues were measured with a skinfold caliper and mid-upper arm circumference. Muscle thickness and strength parameters were measured with ultrasound and handgrip tests.

Results

Median skinfold thickness showed a statistically significant increase in the second week of HD with MCO dialyzers [15 mm (10, 17) to 16 mm (13.3, 19.8), p = 0.04] and remained similar in the 6th month (p = 0.08). There was a gradual increase in median mid-upper arm circumference with a significant increase in the 6th month [28 (27, 29.5), 28.5 cm (27, 30), and 30.6 cm (26.7, 32), respectively, p = 0.03]. Significant increases were detected in the measurements of all four abdominal muscle groups (p = 0.03 for rectus abdominis and external oblique; p = 0.002 for internal oblique and transversus abdominis) in the 2nd week of MCO dialyzers and remained similar in the 6th month. Median RF and GCM thicknesses also significantly increased in the 2nd week (p = 0.001 and p < 0.001, respectively). The thicknesses of the external oblique, internal oblique, transversus abdominis, and rectus femoris muscles showed no significant differences in the 6th month. We also observed significant increases in the median GCM fibril length and GCM fibril pennation (p = 0.01 and p = 0.008, respectively) in the 2nd week, which also remained similar in the 6th month. The handgrip strength test showed a gradual increase at each time point without statistical significance.

Conclusion

MCO dialyzers provide increased fat and muscle mass, which might be due to their better clearance of uremic toxins compared to low-flux dialyzers. This study serves as a hypothesis-generating investigation; larger randomized controlled trials are required to validate the hypothesis.

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中截止透析器对脂肪组织和肌肉质量指数的影响。

背景：中截止（MCO）透析器被设计用于清除大中等分子量的尿毒症毒素和细胞因子，这些毒素和细胞因子也与肌肉减少症的发病机制有关。目的：探讨MCO透析器对脂肪和肌肉质量的短期和长期影响。方法：这项单中心前瞻性交叉研究包括20例使用低通量（LF）透析器治疗的维持性血液透析（MHD）患者。在LF透析器下测量基线参数，并在切换到MCO透析器后的第2周和第6个月重复。用皮褶卡尺和中上臂围测量脂肪组织。通过超声和握力试验测量肌肉厚度和强度参数。结果：使用MCO透析剂治疗HD后第2周，中位皮囊厚度有统计学意义的增加[15 mm (10,17) ~ 16 mm (13.3, 19.8), p = 0.04]，第6个月保持不变（p = 0.08）。中上臂围度逐渐增加，在第6个月显著增加[分别为28（27,29.5）、28.5 cm（27, 30）和30.6 cm (26.7, 32), p = 0.03]。所有四个腹肌群的测量结果均显著增加(腹直肌和外斜肌p = 0.03；p = 0.002（腹内斜肌和腹横肌）在MCO透析第2周，并在第6个月保持相似。中位RF和GCM厚度在第2周也显著增加（p = 0.001和p）。结论：与低通量透析器相比，MCO透析器提供了更多的脂肪和肌肉质量，这可能是由于它们对尿毒症毒素的清除能力更好。本研究是一项假设生成调查；需要更大规模的随机对照试验来验证这一假设。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Artificial organs 工程技术-工程：生物医学

CiteScore

4.30

自引率

12.50%

发文量

303

审稿时长

4-8 weeks

期刊介绍： Artificial Organs is the official peer reviewed journal of The International Federation for Artificial Organs (Members of the Federation are: The American Society for Artificial Internal Organs, The European Society for Artificial Organs, and The Japanese Society for Artificial Organs), The International Faculty for Artificial Organs, the International Society for Rotary Blood Pumps, The International Society for Pediatric Mechanical Cardiopulmonary Support, and the Vienna International Workshop on Functional Electrical Stimulation. Artificial Organs publishes original research articles dealing with developments in artificial organs applications and treatment modalities and their clinical applications worldwide. Membership in the Societies listed above is not a prerequisite for publication. Articles are published without charge to the author except for color figures and excess page charges as noted.