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Abstract: FR-PO477

A 1-Year Study on the Effects of Hemodialysis Using Dialyzer with Medium Cut-Off Membrane

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Jung, Jong-Hwan, Wonkwang university hospital, Iksan, Jeonlabukdo, Korea (the Republic of)
  • Kang, Heerim, Wonkwang university hospital, Iksan, Jeonlabukdo, Korea (the Republic of)
  • Ahn, Seon-Ho, Wonkwang university hospital, Iksan, Jeonlabukdo, Korea (the Republic of)
Background

Medium cut-off (MCO) membrane is a dialyzer with enhanced sieving properties for soultes. An internal filtration of MCO membrane facilitated filtration of large middle molecules, and enhanced fitration of small molecules withtout replacement fluid. A long-term study for several markers after use of MCO membrane is few. We evaluated the various effects related with MCO membrane for 1 year in patients with ESRD.

Methods

Total 40 patients were analyzed for 1 year. The enrolled patients were > 18 years old and were on hemodialysis (HD) using high flux (HF) membrane for >3 months before enrolment. We prospectively collected serum samples with 3-month interval for 1 year. All patients were divided into control (HF, n=20) and MCO (MCO, n=20) group.The patients with serum albumin of > 3.5 g/dL and clinical sign, such as uncontrolled hyperparathyroidism or hyperphosphatemia, were included in MCO group. We measured and calculated serum markers, including parathyroid hormone (PTH), C-reactive protein (CRP), phosphate, hemoglobin (Hb), total protein, albumin, and spKt/V with 3-month interval.

Results

Compared to control group, patients in MCO group were younger and showed higher values of serum albumin and phosphate. In MCO group, serum protein and albumin decreased significantly over time (p <0.05), but serum albumin compared with serum protein did not decrease significantly since 6 months (p =0.056). Serum albumin increased significantly after 6 months in MCO group (p =0.012). The spKt/V increased until 6 months, but it didnot increased significantly since 6 months in MCO group (p =0.072). Several markers such as serum phosphate, calcium, CRP and Hb except for PTH did not show significant changes in both groups. Unexpectedly, PTH increased singnificantly in both groups. In analysis of differences between two groups over time, there was a significant difference only in change of serum phosphate (p =0.030).

Conclusion

Baseline levels of serum phosphate and albumin were high in MCO group due to selection bias. However, this study showed that albumin loss in MCO group was not significant after 6 months, and the spKt/V value in MCO group increased until at least 6 months. Moreover, we could recognize the possibility for hyperphosphatemia reduction in MCO group. Thus, HD using MCO membrane may be superior in clearance of small solutes and be not inferior in albumin loss for 1 year.