Protein-Bound Uremic Toxins Removal with MCO Membranes: A Pilot Study Showing No Superiority over High-Flux Dialysis.

IF 2.2 3区医学 Q3 HEMATOLOGY

Blood Purification Pub Date : 2025-06-18 DOI:10.1159/000546721

Francisca Aranda, Bárbara Segovia-Hernández, Constanza Verdugo, Cristian Pedreros-Rosales, Armando Rojas, Gonzalo Ramírez-Guerrero

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引用次数: 0

Abstract

Background: Protein-bound uremic toxins such as advanced glycation end products (AGEs) are poorly cleared by conventional dialysis. Medium cut-off (MCO) membranes have been proposed to enhance their removal, but clinical evidence remains limited.

Methods: In this prospective pilot study, eight maintenance hemodialysis patients were assigned to receive a single dialysis session using either an MCO or high-flux (HF) membrane. Serum levels of N-carboxymethyllysine (CML), soluble receptor for AGEs (sRAGE), and prolactin were measured pre- and post-dialysis. Reduction ratios corrected for hemoconcentration (RRc) were compared between groups.

Results: The median RRc for CML was similar between MCO (36.9%) and HF (35.6%) membranes (p = 0.686). sRAGE reduction was lower with MCO membranes (21.8% vs. 41.9%, p = 0.114), while prolactin clearance was slightly higher (58.1% vs. 50.9%, p = 0.486). No statistically significant differences were observed.

Conclusion: MCO membranes did not demonstrate superior removal of protein-bound toxins compared to high-flux membranes in this pilot study. These findings highlight the need for alternative strategies, such as adsorption, and larger studies to define the clinical utility of MCO technology.

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用MCO膜去除蛋白结合的尿毒症毒素：一项初步研究显示没有比高通量透析优越。

背景：蛋白质结合的尿毒症毒素，如晚期糖基化终产物（AGEs）在常规透析中清除效果较差。中截止膜（Medium cut-off， MCO）已被提出用于增强其去除，但临床证据仍然有限。方法：在这项前瞻性先导研究中，8名维持性血液透析患者被分配接受单次透析，使用MCO或高通量（HF）膜。测定透析前后血清n -羧甲基赖氨酸（CML）、AGEs可溶性受体（sRAGE）和催乳素水平。比较两组间经血凝校正的还原比（RRc）。结果：CML的中位RRc在MCO膜（36.9%）和HF膜（35.6%）之间相似（p = 0.686）。MCO膜的sRAGE降低率较低（21.8%比41.9%,p = 0.114），而催乳素清除率略高（58.1%比50.9%,p = 0.486）。差异无统计学意义。结论：在这项初步研究中，与高通量膜相比，MCO膜没有表现出更好的去除蛋白质结合毒素的能力。这些发现强调需要替代策略，如吸附和更大规模的研究来确定MCO技术的临床应用。

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

Blood Purification 医学-泌尿学与肾脏学

CiteScore

5.80

自引率

3.30%

发文量

审稿时长

6-12 weeks

期刊介绍： Practical information on hemodialysis, hemofiltration, peritoneal dialysis and apheresis is featured in this journal. Recognizing the critical importance of equipment and procedures, particular emphasis has been placed on reports, drawn from a wide range of fields, describing technical advances and improvements in methodology. Papers reflect the search for cost-effective solutions which increase not only patient survival but also patient comfort and disease improvement through prevention or correction of undesirable effects. Advances in vascular access and blood anticoagulation, problems associated with exposure of blood to foreign surfaces and acute-care nephrology, including continuous therapies, also receive attention. Nephrologists, internists, intensivists and hospital staff involved in dialysis, apheresis and immunoadsorption for acute and chronic solid organ failure will find this journal useful and informative. ''Blood Purification'' also serves as a platform for multidisciplinary experiences involving nephrologists, cardiologists and critical care physicians in order to expand the level of interaction between different disciplines and specialities.