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Comparison of four medium cut-off dialyzers

Francisco Maduell1, José Jesús Broseta1, Diana Rodríguez-Espinosa1

  • 1Department of Nephrology, Hospital Clínic Barcelona, Barcelona, Spain.

Clinical Kidney Journal
|November 16, 2022
PubMed
Abstract

Insights

Four new medium cut-off (MCO) dialyzers show comparable safety and efficacy for expanded hemodialysis (HDx), outperforming standard hemodialysis (HD) and nearing hemodiafiltration (HDF) performance.

Area of Science:

  • Nephrology
  • Biomedical Engineering
  • Medical Devices

Background:

  • New medium cut-off (MCO) dialyzers have been developed for expanded hemodialysis (HDx).
  • Comparison of these MCO dialyzers against each other and against high-flux hemodialysis (HD) and post-dilution hemodiafiltration (HDF) is crucial.

Purpose of the Study:

  • To compare the safety and efficacy of four novel MCO dialyzers.
  • To evaluate their performance against conventional high-flux HD and HDF treatments.

Main Methods:

  • A prospective study involving 23 patients undergoing six dialysis sessions.
  • Inclusion of FX80 Cordiax (HD and HDF) and four MCO dialyzers (Phylther 17-SD, Vie-18X, Elisio HX19, Theranova 400) for HDx.
  • Measurement of reduction ratios for various solutes and assessment of dialysate albumin loss.

Main Results:

  • Minimal efficacy differences among MCO dialyzers for small molecules and β2-microglobulin.
  • MCO dialyzers showed superior reduction ratios for larger solutes (myoglobin, κFLC, prolactin, α1-microglobulin, λFLC) compared to HD, and were slightly inferior to HDF.
  • Albumin loss was minimal (<1 g) with HD, moderate (1.5–2.5 g) with HDx and HDF.

Conclusions:

  • The four evaluated MCO dialyzers demonstrate good efficiency and safety, with no significant performance variations among them.
  • Expanded hemodialysis (HDx) using MCO dialyzers is superior to high-flux HD and approaches the efficacy of post-dilution HDF.
Keywords:
dialyzer performanceexpanded hemodialysishemodiafiltrationmedium cut-offsafety

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