Efficacy of Medium Cut-Off Dialyzer and Comparison with Standard High-Flux Hemodialysis

Abstract

<b><i>Background:</i></b> A new medium cut-off (MCO) membranes has been designed to achieve better removal capacities for middle and large middle molecules in hemodialysis (HD) treatment. <b><i>Aim:</i></b> The aim of this study was to evaluate the removal efficacy of Theranova® in standard HD in comparison with standard high-flux HD. <b><i>Methods:</i></b> Four HD patients (M/F 1/4) were included in 12-week observational pilot study in HD with Theranova® 400 and Theranova® 500 dialyzers. Each patient was assessed 4 times, <i>T</i>₀ with high-flux dialyzers, <i>T</i>₁ at 1 month, <i>T</i>₂ at second month, and <i>T</i>₃ at third month, by measuring pre- and post-HD samples of urea, Cr, β2-microglobilin (β2M), myoglobin, albumin, free light chains kappa (FLC-k), and free light chains lambda (FLC-λ). <b><i>Results:</i></b> The data showed a higher average removal rate for all the uremic toxins with Theranova® dialyzers for β2M, myoglobin, FLC-k, and FLC-λ (62.7, 56.9, 63.5, and 54.6%, respectively) during the 3 months. Albumin retention was observed and did not change between <i>T</i>₀ and <i>T</i>₃ (<i>p</i> = 0.379). <b><i>Conclusion:</i></b> Compared to high-flux membranes, MCO membranes show greater permeability for middle molecules in midterm report.