Impact of Medium Cut-Off Dialysis Membranes on Outcomes in COVID-19 Patients With Acute Kidney Injury

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to significant morbidity and mortality worldwide, with acute kidney injury (AKI) emerging as a significant non-pulmonary complication of COVID-19. This study aimed to evaluate the effect of hemodialysis (HD) membrane type on the outcomes of COVID-19 patients with AKI requiring dialysis.

A retrospective analysis was conducted on 82 COVID-19 patients with AKI who required HD between January 2020 and January 2022. Patients were categorized based on the type of dialysis membrane used as medium cut-off (MCO) versus low-flux (LF). Demographic data, clinical characteristics, laboratory findings, and hospital outcomes, including 28-day mortality, were analyzed.

The mean age of the study population was 69.7 ± 11.6 years, with 45% being female. The median time to HD initiation was shorter in the LF group (p < 0.001). Although ICU admission rates were similar between the groups, the 28-day mortality rate was significantly lower in the MCO group (p = 0.03). Multivariate analysis identified ICU admission as an independent risk factor for mortality while using MCO membranes, associated with a reduced mortality risk (OR: 0.344, p = 0.03). MCO membrane was significantly associated with a higher 28-day survival rate by Kaplan-Meier curve analysis with log-rank test (56.8% vs. 33.3%, p = 0.001).

The findings suggest that using MCO membranes in HD may improve survival outcomes in COVID-19 patients with AKI. Further prospective studies are needed to validate these results and elucidate the potential anti-inflammatory benefits of MCO membranes in this patient population.