Medium Cut-Off Versus High-Flux Dialyzers and Changes in Beck Depression Inventory Scores in Maintenance...

Depression is prevalent in maintenance hemodialysis patients and is influenced by the interplay of physical and mental health. Rather than a direct antidepressant effect of dialyzer membrane type, improved clearance of middle and large uremic solutes may alleviate uremia-related symptoms that indirectly influence mood and quality of life.

This prospective observational study compared changes in Beck Depression Inventory (BDI) scores over 6 months between thrice-weekly hemodialysis patients treated with Theranova-400 or FX80 dialyzers.

Fifty participants were included (Theranova-400/FX80: 25/25; median age 52.5 [27.7] years; 27 females; dialysis vintage 60 [86] months). The reduction in BDI scores did not differ significantly between the two groups (p = 0.203). In the within-group analysis, a significant decline was observed in the FX80 arm (-4.72 ± 6.62, p = 0.003) but not in the Theranova-400 arm (-3.20 ± 10.3, p = 0.199). However, in the subgroup of patients with baseline BDI scores > 14, both dialyzer groups showed statistically significant decreases in BDI scores (FX80: 24.7 ± 7.3 to 16.5 ± 6.6, p = 0.016; Theranova-400: 24.1 ± 8.4 to 14.8 ± 10, p = 0.037).

In this exploratory observational study, BDI scores decreased over 6 months in both groups; however, between-group change in BDI did not differ significantly. These findings do not support a dialyzer-specific antidepressant effect of Theranova-400 compared with FX80. Within-group changes, particularly in the FX80 arm, should be interpreted cautiously considering possible repeated-measurement effects, regression to the mean, and unmeasured confounding. Future studies should evaluate whether changes in uremic symptom burden mediate mood-related scores.