Effects of medium cut-off dialysis membranes on inflammation and oxidative stress in patients on maintenance hemodialysis

Yeter, Hasan; Korucu, Berfu; Akcay, Omer Faruk; Derici, Kursat; Derici, Ülver; Arınsoy, Turgay

doi:10.1007/s11255-020-02562-3

Cited by 23 publications

(32 citation statements)

References 35 publications

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“…Nevertheless, no effect on ESA dose was found in other two studies [17,19]. The general oxidative stress and inflammatory status of patients dialyzed by MCO compared with LF and HF was also evaluated [49]. An effect of inflammation improvement, evaluating C-reactive protein removal, was investigated, with no effect of MCO on oxidative stress biomarkers.…”

Section: Hdx Vs Conventional Hdmentioning

confidence: 99%

Expanded Haemodialysis as a Current Strategy to Remove Uremic Toxins

Ciceri

Cozzolino

2021

Toxins

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Chronic kidney disease (CKD) is characterized by the retention of solutes named uremic toxins, which strongly associate with high morbidity and mortality. Mounting evidence suggests that targeting uremic toxins and/or their pathways may decrease the risk of cardiovascular disease in CKD patients. Dialysis therapies have been developed to improve removal of uremic toxins. Advances in our understanding of uremic retention solutes as well as improvements in dialysis membranes and techniques (HDx, Expanded Hemodialysis) will offer the opportunity to ameliorate clinical symptoms and outcomes, facilitate personalized and targeted dialysis treatment, and improve quality of life, morbidity and mortality.

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Section: Hdx Vs Conventional Hdmentioning

confidence: 99%

Expanded Haemodialysis as a Current Strategy to Remove Uremic Toxins

Ciceri

Cozzolino

2021

Toxins

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“…For studies reporting PROs, we considered the risk of bias due to a lack of blinding as low risk of bias (see discussion). Factors contributing to risk of bias included attrition, 16 - 18 , 28 , 32 , 37 lack of risk adjustment, 27 and selection bias. 17 We found no evidence of selective reporting or publication bias.…”

Section: Resultsmentioning

confidence: 99%

Clinical Outcomes With Medium Cut-Off Versus High-Flux Hemodialysis Membranes: A Systematic Review and Meta-Analysis

Kandi

Brignardello‐Petersen

Couban

et al. 2022

Can J Kidney Health Dis

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Background: A novel medium cut-off (MCO) dialyzer (Theranova, Baxter Healthcare, Deerfield, IL, USA) enhances large middle molecule clearance while retaining selectivity for molecules >45 000 Da. Objective: We undertook a systematic review and meta-analysis evaluating clinical outcomes with MCO vs high-flux membranes. Methods: We searched MEDLINE, EMBASE, CINAHL, Cochrane Library, and Web of Science through July 2020, and gray literature sources from 2017. We included randomized (RS) and nonrandomized studies (NRS) comparing MCO and high-flux membranes in adults receiving maintenance hemodialysis. Pairs of reviewers performed study selection, data extraction, and risk of bias assessment in duplicate. We conducted random-effects pairwise meta-analyses to pool results across studies and used the Grading of Recommendations Assessment, Development and Evaluation approach to assess evidence certainty. Results: We identified 22 eligible studies (6 RS, 16 NRS; N = 1811 patients; patient-years = 1546). The MCO dialyzer improved (estimate; 95% confidence interval [CI]; certainty rating) quality of life (mean difference [MD] = 16.7/100 points; 6.9 to 26.4; moderate), Kidney Disease Quality of Life Instrument (KDQOL) subscales—burden (MD = 4.0; 1.1 to 6.9; moderate) and effects (MD = 5.4; 3.2 to 7.6; moderate), pruritus (MD = −4.4; −7.1 to −1.7; moderate), recovery time (MD = −420 minutes; −541 to −299; high), and restless legs syndrome (odds ratio = 0.39; 0.29 to 0.53; moderate). There was little to no difference in all-cause mortality (risk difference = −0.4%; −2.8 to 2.1; moderate) and serious adverse events (rate ratio = 0.63; 0.38 to 1.04; low). MCO dialysis reduced hospitalization (rate ratio = 0.48; 0.27 to 0.84; low), infection (rate ratio = 0.38; 0.17 to 0.85; moderate), hospitalization days (MD = −1.5 days; 95% CI, −2.22 to −0.78; moderate), erythropoiesis resistance index (MD = −2.92 U/kg/week/g/L; 95% CI, −4.25 to −1.6; moderate) and cumulative iron use over 12 weeks (MD = −293 mg; 95% CI, −368 to −218; moderate). We found with low certainty that MCO dialysis had little to no effect on KDQOL symptoms/problem list, pain, and physical health and moderate certainty that MCO dialysis likely has no effect on the KDQOL mental health composite. Conclusions: We found with predominantly moderate certainty that the MCO dialyzer improves several patient-important outcomes with no apparent risks or harms. More definitive studies are needed to better quantify the effects of MCO membranes on mortality, hospitalization, and other rare events.

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“…and the HD modality (e.g., low-and high-flux HD, hemodiafiltration, etc.) [37][38][39][40]. However, these reports are not clear, showing increased, decreased or no changes in the oxidative-inflammatory stress parameters analyzed [37][38][39][40].…”

Section: Introductionmentioning

confidence: 90%

“…[37][38][39][40]. However, these reports are not clear, showing increased, decreased or no changes in the oxidative-inflammatory stress parameters analyzed [37][38][39][40]. On the other hand, the composition of the PD dialysate solutions, together with chronic exposure of the peritoneal membranes, can trigger oxidative stress and inflammation in PD patients [12][13][14]32].…”

Section: Introductionmentioning

confidence: 99%

Oxidative Stress in Patients with Advanced CKD and Renal Replacement Therapy: The Key Role of Peripheral Blood Leukocytes

et al. 2021

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Oxidative stress plays a key role in the pathophysiology of chronic kidney disease (CKD). Most studies have investigated peripheral redox state focus on plasma, but not in different immune cells. Our study analyzed several redox state markers in plasma and isolated peripheral polymorphonuclear (PMNs) and mononuclear (MNs) leukocytes from advanced-CKD patients, also evaluating differences of hemodialysis (HD) and peritoneal dialysis (PD) procedures. Antioxidant (superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), reduced glutathione (GSH)) and oxidant parameters (xanthine oxidase (XO), oxidized glutathione (GSSG), malondialdehyde (MDA)) were assessed in plasma, PMNs and MNs from non-dialysis-dependent-CKD (NDD-CKD), HD and PD patients and healthy controls. Increased oxidative stress and damage were observed in plasma, PMNs and MNs from NDD-CKD, HD and PD patients (increased XO, GSSG and MDA; decreased SOD, CAT, GPX and GSH; altered GSSG/GSH balance). Several oxidative alterations were more exacerbated in PMNs, whereas others were only observed in MNs. Dialysis procedures had a positive effect on preserving the GSSG/GSH balance in PMNs. Interestingly, PD patients showed greater oxidative stress than HD patients, especially in MNs. The assessment of redox state parameters in PMNs and MNs could have potential use as biomarkers of the CKD progression.

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Effects of medium cut-off dialysis membranes on inflammation and oxidative stress in patients on maintenance hemodialysis

Cited by 23 publications

References 35 publications

Expanded Haemodialysis as a Current Strategy to Remove Uremic Toxins

Expanded Haemodialysis as a Current Strategy to Remove Uremic Toxins

Clinical Outcomes With Medium Cut-Off Versus High-Flux Hemodialysis Membranes: A Systematic Review and Meta-Analysis

Oxidative Stress in Patients with Advanced CKD and Renal Replacement Therapy: The Key Role of Peripheral Blood Leukocytes

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