Effect of Expanded Hemodialysis with Theranova® in Patients with COVID-19

Salazar, Maria L.; Pórtoles, José; Recio, Maria De Valdenebro; Rosado, Silvia; Carratalá, Maria del Rosario Llópez; Andreu, Francisco A. Bernabéu; López, A.J. Sánchez; López, Paula

doi:10.1159/000520891

Cited by 3 publications

(1 citation statement)

References 24 publications

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“…In our study, the mean IL-6 was 5.70 pg/mL, which is a similar baseline concentration to previous studies [13]. One observational study showed that expanded hemodialysis improves survival and effectively removes cytokines in patients with COVID-19 [22]. Further studies should reveal whether expanded HD could effectively remove inflammatory cytokines in patients with severe infection.…”

Section: Discussionsupporting

confidence: 89%

Clinical Safety of Expanded Hemodialysis Compared with Hemodialysis Using High-Flux Dialyzer during a Three-Year Cohort

Cho

Jeong

Lee

et al. 2022

JCM

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Expanded hemodialysis (HD) equipped with a medium cut-off (MCO) membrane provides superior removal of larger middle molecules. However, there is still little research on the long-term benefits of expanded HD. Over a three-year period, this observational study evaluated the efficacy and safety profile of expanded HD for inflammatory cytokines, including IL-6. We conducted a prospective cohort study to investigate the inflammatory cytokine changes and a retrospective observational cohort study to investigate long-term clinical efficacy and safety over a three-year period. We categorized the patients according to dialyzer used: MCO and high-flux (HF) dialyzer. The inflammatory cytokines, including IFN-γ, IL-1β, IL-6, and TNF-α, were measured annually. The concentrations and changes of the four cytokines over time did not differ between the HF group (n = 15) and MCO group (n = 27). In both prospective and retrospective (HF group, n = 38; MCO group, n = 76) cohorts, there were no significant differences in either death, cardiovascular events, infections, or hospitalizations. Furthermore, the temporal changes in laboratory values, including serum albumin and erythropoietin prescriptions, did not differ significantly between the two groups in either the prospective or retrospective cohorts. In conclusion, clinical efficacy and safety outcomes, as well as inflammatory cytokines, did not differ with expanded HD compared with HF dialysis during a three-year treatment course, although the level of inflammatory cytokine was stable.

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Section: Discussionsupporting

confidence: 89%

Clinical Safety of Expanded Hemodialysis Compared with Hemodialysis Using High-Flux Dialyzer during a Three-Year Cohort

Cho

Jeong

Lee

et al. 2022

JCM

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Medium cut-off dialyzer for middle molecular uremic toxins in AKI and chronic dialysis

Fiorentino,

La Fergola,

De Rosa

2023

J Nephrol

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Uremic toxins accumulate in patients affected by renal failure and can deposit in different organs, including the kidneys and heart. Given their physicochemical characteristics, uremic toxins can contribute to organ dysfunction due to several pathobiological actions at cellular and molecular levels. Several uremic compounds have been described in serum and plasma from patients with acute kidney injury (AKI) and kidney failure; they are usually classified based on their molecular size and protein-binding properties. In this scenario, new dialytic approaches have been proposed in the last few years with the aim of improving uremic toxin removal. Recent studies which focused on the use of medium cut-off membranes in patients on chronic hemodialysis have shown a discrete ability to remove β2-microglobulin and other middle molecules, such as kappa and lambda free light chains, complement factor D and α1-microglobulin. However, current evidence is mainly based on the impact on short-term outcomes and, consequently, longer observational studies are necessary to confirm the efficacy and safety of the medium cut-off dialyzer. Here we present the state-of-the-art on the clinical application of medium cut-off membranes in AKI and chronic dialysis patients. Graphical abstract

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Expanded hemodialysis: what’s up, Doc?

García-Prieto

Flor

Coll

et al. 2023

Clinical Kidney Journal

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In the last years there has been an increasing interest in expanded hemodialysis (HDx), an emerging renal replacement therapy based on the use of medium cut off membranes (MCO). Thanks to the internal architecture of these type of membranes with a higher pore size and smaller fiber inner diameter to favour internal filtration rate they can increase the removal of larger middle molecules in conventional hemodialysis. Secondarily, several reports suggest that this therapy potentially improve the outcomes for end-stage renal disease patients. However, HDx has not been defined yet and the characteristics of MCO membranes are not well stablished. The aim of this narrative review is to define HDx and summarize the dialyzers that have been used so far to perform this therapy, collect the evidence available on its efficacy and clinical outcomes compared to other hemodialysis technics and settle the bases for its optimal prescription.

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Effect of Expanded Hemodialysis with Theranova® in Patients with COVID-19

Cited by 3 publications

References 24 publications

Clinical Safety of Expanded Hemodialysis Compared with Hemodialysis Using High-Flux Dialyzer during a Three-Year Cohort

Clinical Safety of Expanded Hemodialysis Compared with Hemodialysis Using High-Flux Dialyzer during a Three-Year Cohort

Medium cut-off dialyzer for middle molecular uremic toxins in AKI and chronic dialysis

Expanded hemodialysis: what’s up, Doc?

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