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Abstract: SA-PO414

Expanded Dialysis With Theranova Compared to Conventional High-Flux Hemodialysis: A Randomized Prospective 12-Month Study

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Mok, Maggie ming yee, Tung Wah Hospital, Hong Kong, Hong Kong
  • Lui, Sing-Leung, Tung Wah Hospital, Hong Kong, Hong Kong
  • Chan, Tak Mao Daniel, Queen Mary Hospital, Hong Kong, Hong Kong
Background

Hemodialysis (HD) using medium cut-off (MCO) Theranova enables enhanced clearance of middle molecules. This study investigated the clinical effects of MCO dialysis compared with conventional HD, in Hong Kong where a significant proportion of patients were on twice-weekly HD.

Methods

Adult chronic HD patients were recruited from two HD units. All patients received high-flux HD over a 6-week run-in period, then were randomized (1:1) to receive high-flux HD or MCO-HD for 12 months. Primary outcomes included nutritional indexes measured by body composition monitor (BCM), and patient-reported symptom parameters. Blood parameters related to nutrition, inflammation, and cardiovascular health were also measured.

Results

Sixty patients were included (30 in each group) with similar baseline characteristics. Body mass index, lean and fat tissue indexes remained stable throughout within and between groups. Serum albumin in the MCO-HD group showed a significant decrease at 6-month (36.23±3.36 g/L) compared with baseline (37.93±2.80 g/L, p=0.043), which was significantly lower than that in controls (38.44±3.43 g/L, p=0.024) at this time-point, but the level increased afterwards and the differences were not sustained. At 12-month, measured serum parameters were similar in the two groups (Tab). Symptoms related to sleep quality, appetite, itchiness, and quality of life as measured by KDQOL-SF™ V1.3 showed no between-group difference. The incidence rates of all adverse events and hospitalizations were similar in the two groups, including events related to fluid status. Overhydration as measured by BCM was not increased in patients on MCO-HD compared with controls, while ultrafiltration was only used in the latter.

Conclusion

MCO-HD with Theranova over 12 months was safe and well tolerated, resulting in similar morphometric and biochemical parameters of nutritional status compared with patients on high-flux HD. Patients treated with MCO-HD showed an initial decrease in serum albumin which returned to prior levels after 6 months.

Tab

Funding

  • Commercial Support –