Erratum to: Performance of Hemodialysis with Novel Medium Cut-Off Dialyzers

Kirsch, Alexander H.; Lyko, Raphael; Nilsson, Lars‐Göran; Amdahl, Michael; Lechner, Petra; Schneider, Andréas; Wanner, Christoph; Rosenkranz, Alexander R.; Krieter, Detlef H.

doi:10.1093/ndt/gfaa322

Cited by 3 publications

(3 citation statements)

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“…We further show that most mediators (8–42 kDa) 31 , 32 tested from dialysate samples were filtered to a greater extent during MCO versus high-flux-HD. Still, and in line with most previous data 20 , 26 , 29 we did not find superior single session elimination kinetics of MCO membranes for any mediator except YKL-40. This could be related to either the size of YKL-40 (42 kDa) or a somewhat different biologic kinetic 10 as discussed below.…”

Section: Discussionsupporting

confidence: 93%

“…Other have independently reported superior and sustained (1–6 months) reduction of larger-sized middle molecules including beta-2-microglobuline (12 kDa) and λ light chain (45 kDa) during MCO versus high-flux-HD or even HDF treatment 20 , 24 , 29 , 30 . Yet, in terms of elimination of inflammatory mediators, they reached conflicting conclusions.…”

Section: Discussionmentioning

confidence: 99%

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A randomized prospective cross over study on the effects of medium cut-off membranes on T cellular and serologic immune phenotypes in hemodialysis

Lorenz

Shen

Hausinger

et al. 2022

Sci Rep

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Extended cut-off filtration by medium cut-off membranes (MCO) has been shown to be safe in maintenance hemodialysis (HD). The notion of using them for the control of chronic low-grade inflammation and positively influencing cellular immune aberrations seems tempting. We conducted an open label, multicenter, randomized, 90 day 2-phase cross over clinical trial (MCO- vs. high flux-HD). 46 patients underwent randomization of which 34 completed the study. Dialysate- or pre- and post-dialysis serum inflammatory mediators were assayed for each study visit. Ex vivo T cell activation was assessed from cryopreserved leucocytes by flow cytometry. Linear mixed models were used to compare treatment modalities, with difference in pre-dialysis serum MCP-1 levels after 3 months as the predefined primary endpoint. Filtration/dialysate concentrations of most mediators, including MCP-1 (mean ± SD: 10.5 ± 5.9 vs. 5.1 ± 3.8 pg/ml, P < 0.001) were significantly increased during MCO- versus high flux-HD. However, except for the largest mediator studied, i.e., YKL-40, this did not confer any advantages for single session elimination kinetics (post-HD mean ± SD: 360 ± 334 vs. 564 ± 422 pg/ml, P < 0.001). No sustained reduction of any of the studied mediators was found neither. Still, the long-term reduction of CD69+ (P = 0.01) and PD1+ (P = 0.02) activated CD4+ T cells was striking. Thus, MCO-HD does not induce reduction of a broad range of inflammatory mediators studied here. Long-term reduction over a 3-month period was not possible. Increased single session filtration, as evidenced by increased dialysate concentrations of inflammatory mediators during MCO-HD, might eventually be compensated for by compartment redistribution or increased production during dialysis session. Nevertheless, lasting effects on the T-cell phenotype were seen, which deserves further investigation.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

A randomized prospective cross over study on the effects of medium cut-off membranes on T cellular and serologic immune phenotypes in hemodialysis

Lorenz

Shen

Hausinger

et al. 2022

Sci Rep

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“…Compared with intermittent hemodialysis, continuous hemodialysis was hemodynamically stable. It was easy and unrestricted to adequately rehydrate, which provided better metabolic control and clearance of the body's inflammatory mediators (Kirsch et al, 2017). Lin S Y found that most scholars believed that continuous blood purification (CBP) was safe and well tolerated in patients with severe ARF, which was especially suitable for patients who were prone to hypotension and cardiac insufficiency during IHD treatment (Lin and Yi-Wen, 2018), If the patient's blood pressure is low, it may aggravate hypotension, cardiac insufficiency or arrhythmia during blood purification.…”

Section: Introductionmentioning

confidence: 99%

Effect of replacement therapy (CRRT) and hemodialysis (IHD) on severe acute renal failure

Zhang

Yuan

2023

Front. Pharmacol.

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Hyperkalemia, metabolic acidosis, and acute uremia are the main symptoms in patients with severe acute renal failure (SARF). Its clinical symptoms are obvious, and it is extremely harmful. It needs to take active and effective measures for treatment. CRRT refers to any extracorporeal blood purification treatment technique designed to replace impaired renal function for 24 h or nearly 24 h. Hemodialysis treatment is a treatment process in which the patient’s blood is discharged from the body, passes through the dialysis membrane and dialysis machine, removes excess toxins and water in the body, corrects electrolyte and acid-base disorders, and then returns the blood to the body. In order to explore the efficacy of replacement therapy and hemodialysis in the treatment of severe acute renal failure, the data samples were randomly divided into observation group and control group, who were given conventional treatment, hemodialysis and replacement therapy, respectively. Clinical data show that after replacement therapy and hemodialysis in patients with severe acute renal failure in the observation group, the levels of parathyroid hormone, renin, and quality of life were all improved, with an improvement rate of 9.47%, which has certain promotional value.

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Elimination of Medium/High Molecular Weight Solutes. Comparison of High Flow Hemodialysis with Extended Hemodialysis

Manuel Benítez,

Sergio,

Maria R

et al. 2024

J Clini Nephrol

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Introduction: Post-dilution online hemodiafiltration is the most efficient extracorporeal depurative treatment of CKD. Recently a new type of membrane has been developed, with a higher cut-off point also called a medium cut-off point, which has the capacity to eliminate higher molecular weight molecules in hemodialysis. The hemodialysis performed with these membranes has been called “Expanded Hemodialysis”. Objective: Compare the purifying efficacy of medium and high molecular weight molecules in patients dialyzed with high-flux hemodialysis, VitaPES 210HF, and with patients treated with expanded hemodialysis with the medium cut-off dialyzer, Elisio-HX. We also assessed the effect that the increased removal of inflammatory mediators by MCO hemodialysis had on fecal Calprotectin levels. Patients and methods: This is a prospective observational cross-over study in which 8 prevalent hemodialysis patients were followed for two months. Blood levels of IL-6, C-reactive protein (CRP), β2-microglobulin, Kappa and Lambda immunoglobulin light chains, and serum albumin were determined before and after each hemodialysis session. Results: The percentage of reduction of medium and higher molecular weight molecules: β2microglobulin, IL-6, Kappa and Lambda chains and CRP were higher with the Elisio-21HX dialyzer compared to the VitaPES 210HF dialyzer. There was no difference in albumin clearance between the two dialyzers. Fecal calprotectin levels were lower in patients dialyzed with Elisio-21HX. Conclusion: The medium cutoff dialyzer, Elisio-HX, is more efficient in the elimination of medium/high molecular weight molecules than the VitaPES HF high-flux dialyzer, with the same albumin elimination. Improving inflammation at the local intestinal level with lower levels of fecal Calprotectin.

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Erratum to: Performance of Hemodialysis with Novel Medium Cut-Off Dialyzers

Cited by 3 publications

References 0 publications

A randomized prospective cross over study on the effects of medium cut-off membranes on T cellular and serologic immune phenotypes in hemodialysis

A randomized prospective cross over study on the effects of medium cut-off membranes on T cellular and serologic immune phenotypes in hemodialysis

Effect of replacement therapy (CRRT) and hemodialysis (IHD) on severe acute renal failure

Elimination of Medium/High Molecular Weight Solutes. Comparison of High Flow Hemodialysis with Extended Hemodialysis

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