A Pilot, Randomized, Double-Blind, Cross-Over Study of High Cut-Off versus High-Flux Dialysis Membranes

Abstract

Background: High cut-off (HCO) membranes may increase β₂-microglobulin (β2M) removal compared to standard high-flux membranes.Methods:Eight stable haemodialysis patients were enrolled in a prospective, randomized, double-blind, cross-over study and treated with HCO and high-flux membranes for 2 weeks each, between a 1-week washout period. Primary end point was serum β2M removal. Secondary end points included serum albumin concentrations, albumin and small solute clearances. Results: HCO membranes achieved significantly lower median post-dialysis β2M concentration (10.8 vs. 14.2 mg/l; p = 0.003) and greater β2M reduction ratio (62.3 vs. 51.0%; p < 0.002). Serum albumin decreased with HCO membranes (from 36 to 29.5 g/l; p = 0.018) but increased to 33.5 g/l after the washout period. Albumin clearance was significantly greater with HCO membranes (2.2 vs. 0.06 ml/min; p = 0.004). Urea reduction ratio was significantly lower with HCO membranes (64.8 vs. 71.5%; p < 0.001). Conclusion: β2M removal was superior with HCO membranes. Reduction in serum albumin and lower small solute clearance require further investigations.