Mp530comparison of Hemodialysis With Medium Cut-Off Dialyzer and One-Line Hemodiafiltration on the Removal of Small and Middle Size Molecules: A Pilot Study

Belmouaz, Mohamed; Diolez, Jeremy; Bauwens, Marc; Écotière, Laure; Desport, Éstelle; Bridoux, Frank

doi:10.1093/ndt/gfx175.mp530

Cited by 2 publications

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“…Additional studies with increased patient numbers and treatment periods are ongoing to generate more evidence [50] . [47,48] Retrospective observation 10 6 months No significant difference between ol-HDF and MCO-HD for median serum albumin and pre-albumin levels [49] …”

Section: Plasma Clearance During Simulated Dialysis Treatmentmentioning

confidence: 99%

Membrane Innovation in Dialysis

Boschetti‐de‐Fierro

Beck

Hildwein

et al. 2017

Expanded Hemodialysis: Innovative Clinical Approach in Dialysis

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Despite advances in renal replacement therapy, the adequate removal of uremic toxins over a broad molecular weight range remains one of the unmet needs in hemodialysis. Therefore, membrane innovation is currently directed towards enhanced removal of uremic toxins and increased membrane permeability. This chapter presents a variety of opportunities where innovation is brought into dialysis membranes. It covers the membrane formation from solution, describing different approaches to control the phase inversion process through additives that either swell in the polymer solution or influence the pore shrinkage during the membrane drying process. Additionally, large-scale manufacturing is described, and the influence of raw materials, spinning, and drying processes on membrane selectivity are presented. Finally, new characterization methods developed for the latest innovations around the application of membranes in dialysis are discussed, which allow the membrane performance for removal of a broad range of uremic toxins and the expected albumin loss in clinical use. © 2017 S. Karger AG, BaselTo treat approximately 3.2 million end-stage renal disease patients with extracorporeal blood purification, approximately 320 million dialyzers are required worldwide in 2017. The number of dialysis recipients is growing by an estimated 6% annually. To fulfill current and future demands for dialyzers, large-scale manufacturing is required. The production of membranes and dialyzers requires advanced and automated manufacturing technology to fulfill the specific quality needs for medical applications and the continuously increasing demand [1] .

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Section: Plasma Clearance During Simulated Dialysis Treatmentmentioning

confidence: 99%

Membrane Innovation in Dialysis

Boschetti‐de‐Fierro

Beck

Hildwein

et al. 2017

Expanded Hemodialysis: Innovative Clinical Approach in Dialysis

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Effects of a medium cut-off (Theranova®) dialyser on haemodialysis patients: a prospective, cross-over study

Cozzolino

Magagnoli

Ciceri

et al. 2019

Clinical Kidney Journal

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Background Despite significant advances in haemodialysis (HD) in recent decades, current dialysis techniques are limited by inadequate removal of uraemic solutes such as middle molecules and protein-bound uraemic toxins. Novel medium cut-off (MCO) membrane or ‘expanded haemodialysis’ (HDx) provides diffusive removal of conventional and large middle molecular weight uraemic toxins, with marginal albumin leak. Methods This prospective, open-label, controlled, cross-over pilot study compared HDx (novel MCO membrane Theranova® 400) and conventional HD in 20 prevalent HD patients. Biochemical, dialysis adequacy and safety measures (adverse events, infections and hospitalization frequency) were recorded. Ten patients underwent conventional HD high-flux dialyser and 10 patients underwent HDx for 3 months, and the patients then switched and received the other treatment for a further 3 months. Results Treatment with HDx was associated with a significant reduction in serum albumin concentration [median (interquartile range) reduction −0.45 g/dL (−0.575 to −0.05); P = 0.025]. However, median albumin levels were ≥3.5 g/dL and no patients had clinical symptoms of hypoalbuminaemia or needed intravenous albumin administration. The number of infections was lower in patients treated with HDx (n = 7/19) compared with patients treated with HD (n = 14/20; P = 0.03). Patients treated with HDx had reduced levels of interleukin (IL)-1β (from 0.06 ± 0.02 pg/mL versus 0.28 ± 0.18 pg/mL with HD) and IL-6 (6.45 ± 1.57 pg/mL versus 9.48 ± 2.15 pg/mL), while tumour necrosis factor-α levels remain unchanged. Conclusions This study demonstrates that the chronic use of the novel MCO dialyser Theranova® appears to be safe and well-tolerated, without serious side effects or hypoalbuminaemia, as well as fewer infections. These results need to be confirmed in larger randomized clinical trials.

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Mp530comparison of Hemodialysis With Medium Cut-Off Dialyzer and One-Line Hemodiafiltration on the Removal of Small and Middle Size Molecules: A Pilot Study

Cited by 2 publications

References 0 publications

Membrane Innovation in Dialysis

Membrane Innovation in Dialysis

Effects of a medium cut-off (Theranova®) dialyser on haemodialysis patients: a prospective, cross-over study

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