#6648 LONG TERM EFFECT OF MEDIUM CUT-OFF DIALYZER ON MIDDLE UREMIC TOXINS

Abstract

Abstract Background and Aims Better removal capacities for middle and large middle molecules in hemodialysis was achieved in (HD) treatment with the new medium cut-off (MCO) membranes. The aim of this study was to evaluate the long term removal efficacy of Theranova® in standard HD in comparison with standard high-flux HD. Method 11 patients were assigned to high flux and 11 to MCO membranes in 12-months observational study. Each patient was assessed every three months from T0 with high-flux dialyzers, T1 to T5 with MCO at first, third, sixth, nineth and twelfth month by measuring pre- and post-HD samples of β2-microglobilin (β2M), myoglobin, albumin, free light chains kappa (FLC-k), and free light chains lambda (FLC-λ). The cumulative change from as RR from T0 to T5 was defined as long term outcome. Results The data showed a higher average removal rate (RR) for all the uremic toxins with Theranova® dialyzers for β2M, myoglobin, FLC-k, and FLC-λ (66.1, 53.2, 59.2.5, and 60.9%, respectively) compared to high flux (57.1, 10.8, 29.9 and 37.4%, respectively). The analyses on the cumulative RR from T0 to T5 found significant decrement of β2M, myoglobin, FLC-λ in MCO vs high flux group where those values significantly raised (14.9 vs −6.1, p = 0.043; 27.7 vs −7.8, p = 0.001; 21.9 vs −4.2, p = 0.017, respectively). The FLC-k showed borderline significantly better removal with MCO (17.8 vs 8.4. p = 0.067). The distribution of patients with 12 month middle molecules reduction was much better in the MCO group. Albumin retention was better in MCO group and did not change between T0 and T5 (p = 0.824). Conclusion Compared to high-flux membranes, MCO membranes show greater permeability for middle molecules and albumin stability in long-term report. Their use in HD standard setting is effective and safe.