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Abstract: FR-PO465

In Vitro Cytokine Removal: Comparison of Conventional High-Flux Dialyzers and Middle-Cut-Off Dialyzer (Theranova HDx)

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Koball, Sebastian, University of Rostock, Rostock, Germany
  • Heskamp, Benjamin, Fraunhofer, Rostock, Germany
  • Körtge, Andreas, Fraunhofer Institute for Cell Therapy and Immunology IZI, Rostock, Germany
  • Frimmel, Silvius, Rostock University Medical Center, Rostock, Germany
  • Hinz, Michael, Universität Rostock, Rostock, Germany
  • Mitzner, Steffen R., University of Rostock, Rostock, Germany
Background

The removal of inflammatory mediators is important for the treatment of acute (ARF) or chronic renal failure (CRF). In ARF and sepsis, attempts is made to achieve removal through the use of high-volume treatments or adsorbers. In CRF, this has so far not been sufficiently addressed, but is important for mortality (MIA syndrome). By using new MCO filters (Baxter Theranova (HDx)), an improvement of cytokine status seems to be possible in both areas. The effectiveness of HDx in the removal of interleukins (interleukin 6, interleukin 10 and TNFalpha in hemodialysis treatments will be assessed.

Methods

The efficacy of HDx was compared to conventional high-flux dialyzers (Fresenius FX80). The measurements were performed in vitro in a 3l pool of fresh frozen plasma (citrate and heparin anticoagulation). IL6 (24.5 kDa) IL10 (18.6 kDa, dimer)) and TNFalpha (17.4 kDa, trimer) were added to plasma (1.5 μg/l each). Samples were taken before and after the dialyzer (after 5, 15, 30, 60, 120 and 180 minutes). In addition to cytokines, albumin and total serum protein concentrations were measured (LEGEND MAX Human IL-6/IL-10/TNF-α; Cobas Mira Plus; Roche LT-AB0103, LT-TP0253). Every test was repeated 5 times.

Results

Theranova HDx showed significantly higher removal rates of all tested cytokines over a period of 180 minutes. A comparison of the concentrations at the beginning and end of the measurements showed:
IL-6 reduction - HDx about 80% / FX80 about 40%.
IL-10 reduction - HDx about 50% and FX80 about 10%.
TNF-αReduction - HDx about 25%; FX80 no reduction
The concentration of albumin and total serum protein was not significant different during the treatment in both groups.

Conclusion

Hemodialysis therapy with Theranova HDx appears to be a superior therapy option for the removal of cytokines. This opens up new treatment options for both acute and chronic dialysis patients. However, clinical studies are still necessary to assess the significance in patient treatment.