Effect of Medium Cut-Off Dialyzers on Calcification Propensity in Hemodialysis Patients: A 6-Month Prospective Pilot Study

IF 1.4 4区医学 Q3 UROLOGY & NEPHROLOGY

Hemodialysis International Pub Date : 2025-10-24 DOI:10.1111/hdi.70033

Berfu Korucu, Joyce Xu, Henrike Hamer, Robert de Jonge, Serpil Muge Deger, Marc Vervloet

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引用次数: 0

Abstract

Background

T50 is a serum-based measure of calcification propensity and a predictor of cardiovascular risk and mortality in hemodialysis (HD) patients. Cardiovascular disease is in part driven by uremic toxins. Medium cut-off (MCO) dialyzers enhance the clearance of middle molecular weight (MW) uremic toxins compared to conventional dialyzers. However, the long-term impact of MCO dialyzers on pre-dialysis and post-dialysis T50 scores remains unknown.

Methods

The study included maintenance HD patients on low-flux (LF) dialyzers. Pre- and post-dialysis serum samples were collected in mid-week HD sessions: first with LF dialyzers (baseline) and then 6 months after switching to MCO dialyzers. Change in T50 was analyzed for a single HD treatment under LF and MCO dialyzers, and baseline and sixth-month pre-dialysis T50 scores were compared.

Results

Fifteen patients were included. Pre- and post-dialysis percent improvement in T50 for LF and MCO dialyzers were similar (85.2% [45.0, 282.7] and 56.3% [21.1, 238.6], respectively, p = 0.35). Pre-dialysis T50 after 6 months on MCO was comparable to the baseline (p = 0.73). Pre-dialysis T50 at baseline had an inverse association with improvement in T50 after a single HD treatment (β = −0.88; 95% CI: −1.18 to −0.57; p < 0.01), and smoking had a direct association with pre-dialysis T50 after 6 months of MCO treatment (β = −172; 95% CI: −287 to −56.8; p = 0.02).

Conclusion

MCO dialyzers do not confer additional benefits in improving serum calcification propensity, compared to LF dialyzers. Our data do not support a significant contribution of middle MW uremic toxins' removal to T50 scores.

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中等临界值透析器对血液透析患者钙化倾向的影响：一项为期6个月的前瞻性先导研究。

背景：T50是血透（HD）患者钙化倾向的一种基于血清的测量方法，也是心血管风险和死亡率的预测因子。心血管疾病部分是由尿毒症毒素引起的。与传统的透析器相比，中截止（MCO）透析器增强了对中分子量（MW）尿毒症毒素的清除。然而，MCO透析器对透析前和透析后T50评分的长期影响尚不清楚。方法：研究对象为使用低通量（LF）透析器的维持性HD患者。透析前和透析后的血清样本在周中HD会议中收集：首先使用LF透析器（基线），然后在切换到MCO透析器6个月后。分析在LF和MCO透析器下单一HD治疗的T50变化，并比较基线和透析前6个月T50评分。结果：纳入15例患者。LF和MCO透析患者透析前和透析后T50改善百分比相似（分别为85.2%[45.0,282.7]和56.3% [21.1,238.6],p = 0.35）。MCO治疗6个月后透析前T50与基线相当（p = 0.73）。透析前基线T50与单次HD治疗后T50的改善呈负相关（β = -0.88; 95% CI: -1.18至-0.57;p）结论：与LF透析器相比，MCO透析器在改善血清钙化倾向方面没有额外的益处。我们的数据不支持中重度尿毒症毒素去除对T50评分的显著贡献。

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

Hemodialysis International UROLOGY & NEPHROLOGY-

CiteScore

2.50

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Hemodialysis International was originally an annual publication containing the Proceedings of the International Symposium on Hemodialysis held in conjunction with the Annual Dialysis Conference. Since 2003, Hemodialysis International is published quarterly and contains original papers on clinical and experimental topics related to dialysis in addition to the Annual Dialysis Conference supplement. This journal is a must-have for nephrologists, nurses, and technicians worldwide. Quarterly issues of Hemodialysis International are included with your membership to the International Society for Hemodialysis. The journal contains original articles, review articles, and commentary to keep readers completely updated in the field of hemodialysis. Edited by international and multidisciplinary experts, Hemodialysis International disseminates critical information in the field.