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Effect of Medium Cut-Off Dialyzers on Calcification Propensity in Hemodialysis Patients: A 6-Month Prospective Pilot

Berfu Korucu1, Joyce Xu2,3, Henrike Hamer3

  • 1Department of Nephrology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.

Hemodialysis International. International Symposium on Home Hemodialysis
|October 24, 2025
PubMed

Insights

Medium cut-off (MCO) dialyzers did not improve serum calcification propensity (T50) in hemodialysis patients compared to low-flux (LF) dialyzers. Enhanced clearance of uremic toxins by MCO dialyzers did not significantly impact T50 scores.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Biochemistry

Background:

  • T50 measures calcification propensity and predicts cardiovascular risk in hemodialysis (HD) patients.
  • Cardiovascular disease in HD patients is linked to uremic toxins.
  • Medium cut-off (MCO) dialyzers improve clearance of middle molecular weight (MW) uremic toxins over conventional dialyzers.

Purpose of the Study:

  • To investigate the long-term impact of MCO dialyzers on pre- and post-dialysis T50 scores.
  • To compare the efficacy of MCO versus low-flux (LF) dialyzers in improving T50.
  • To assess the relationship between T50 and uremic toxin clearance.

Main Methods:

  • Maintenance HD patients on LF dialyzers were studied.
  • Pre- and post-dialysis serum samples were collected at baseline (LF) and 6 months after switching to MCO dialyzers.
  • Changes in T50 were analyzed for single HD treatments, and pre-dialysis T50 scores were compared over time.

Main Results:

  • Pre- and post-dialysis T50 improvement percentages were similar between LF and MCO dialyzers (p=0.35).
  • Pre-dialysis T50 after 6 months on MCO was comparable to baseline (p=0.73).
  • Baseline T50 inversely correlated with T50 improvement post-HD (p<0.01), and smoking was associated with higher pre-dialysis T50 on MCO (p=0.02).

Conclusions:

  • MCO dialyzers offer no additional benefit over LF dialyzers in improving serum calcification propensity (T50).
  • The removal of middle MW uremic toxins by MCO dialyzers does not significantly contribute to changes in T50 scores.
  • Current evidence does not support MCO dialyzers for improving T50 in HD patients.
Abstract

Keywords:
T50 crystallyzation testcalcification propensityhemodialysismedium cut‐off dialyzersystemic calcification

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