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Abstract: SA-PO412

A Randomized, Open-Label, Crossover Clinical Study to Compare the Effect of Hemodialysis Performed With a Medium Cut-Off Membrane vs. That With a High-Flux Membrane on Endothelial Function

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis


  • Armani, Rachel Gatti, Universidade Federal de Sao Paulo, Sao Paulo, São Paulo, Brazil
  • Carvalho, Aluizio B., Universidade Federal de Sao Paulo, Sao Paulo, São Paulo, Brazil
  • Rocha e Silva, Monique Vercia, Universidade Federal de Sao Paulo, Sao Paulo, São Paulo, Brazil
  • Canziani, Maria Eugenia F., Universidade Federal de Sao Paulo, Sao Paulo, São Paulo, Brazil

Endothelial dysfunction (ED) is considered a marker of vascular complications, especially in patients with chronic kidney disease (CKD). Inflammation and the uremic state contribute to ED in hemodialysis (HD) patients. Recently, the medium cut-off (MCO) HD membrane has been proposed to efficiently remove inflammatory cytokines and higher molecular weight uremic toxins.
The aim of this study was to compare the effect of dialysis with medium cut-off (MCO) or high-flux (HF) membranes on endothelial function of patients on chronic HD.


A prospective, randomized, crossover study in which 32 patients with CKD were dialyzed for 12 weeks with each membrane, including a 4-week washout period between treatments. Endothelial function was assessed by flow-mediated dilation (FMD) using brachial artery ultrasound at weeks 1, 12, 16, and 28.


The population consisted of 59% men, 52.7±13.4 years, 16% non-black, on HD for 8.8(4.1-15.1) years, 72% with arteriovenous fistula. Hypertension was the most common etiology of CKD and 34% of patients had previous cardiovascular disease. Patients were grouped, regardless of treatment sequence, into MCO or HF groups, since no carry-over (p=0.634) or sequence (p=0.998) effects were observed in the FMD assessment. The ANOVA model with repeated measures showed no effects of treatment (p=0.426), time (p=0.972) or interaction (p=0.413) in the comparison of FMD, between the MCO and HF groups.
Figure 1 shows mean and respective 95% confidence interval of FMD (%) per treatment, according to evaluation moments.


Dialysis performed with MCO or HF membranes did not influence endothelial function in patients undergoing chronic HD.


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