Early and Late Effects of Medium Cutoff Dialyzer on Arterial Stiffness in Maintenance Hemodialysis Patients

Introduction

Removing uremic toxins from the body is one of the most critical points in the maintenance hemodialysis (MHD) population. This study aimed to evaluate the effects of medium cutoff (MCO) membranes on pulse wave velocity (PWV) and augmentation index (AIx), early markers of arterial stiffness, in MHD patients over both short- and long-term periods.

Methods

Twenty MHD patients were included in this study. Patients were switched from low-flux to MCO membranes. Hemodynamic parameters and laboratory results were recorded in the low-flux membrane as baseline and the second week and the sixth month after switching to the MCO membranes. PWV and AIx were measured using the IME Mobil-O-Graph.

Findings

The median was 69.5 years old, with 60% female predominance. 35% of the patients were diabetic, 70% had hypertension, and 21.1% were smokers. The median systolic, diastolic blood pressure, mean arterial pressure, and pulse were similar at all study time points. The pulse pressure tended to decrease with a significant reduction in the sixth month (p = 0.73 and p = 0.03). We did not observe any significant differences regarding the PWV measurements (p = 0.71 and p = 0.62) and total vascular resistance (p = 0.23 and p = 0.79). The median AIx decreased during the study time points, with a significant difference between the second-week MCO and the sixth-month MCO measurements (p = 0.04).

Discussion

Our findings underscore the potential benefits of MCO membranes to provide a favorable cardiovascular profile in conventional HD setting.