ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005


The Latest on X

Kidney Week

Please note that you are viewing an archived section from 2022 and some content may be unavailable. To unlock all content for 2022, please visit the archives.

Abstract: SA-PO410

Improved Removal of Free Light Chains by Hemodialysis With Medium Cut-Off Dialyzer

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis


  • Lee, Jung eun, Yonsei University College of Medicine, Seodaemun-gu, Seoul , Korea (the Republic of)
  • Jhee, Jong Hyun, Yonsei University College of Medicine, Seodaemun-gu, Seoul , Korea (the Republic of)
  • Park, Hyeong cheon, Yonsei University College of Medicine, Seodaemun-gu, Seoul , Korea (the Republic of)

Free light chains (FLCs), well known middle molecular uremic toxins, are frequently elevated in patients with renal impairment. They are associated with chronic inflammation and vascular calcification and often elevated FLCs lead to increased morbidity and mortality. Recent studies suggest that middle to large molecules are more efficiently removed by medium cut-off (MCO) dialyzers than high-flux dialyzer. This study aimed to investigate the efficacy of MCO dialyzer on elimination of FLC compared to high-flux dialyzer in patients undergoing hemodialysis.


A randomized prospective study was performed with 68 participants, divided into MCO dialyzer group (n = 34) and high-flux dialyzer group (n = 34). Serum levels of middle to large molecules including kappa and lambda FLCs, and beta-2 microglobulin, and their reduction ratios were measured at baseline and after 6 months, and compared between two groups.


Baseline serum levels of albumin, calcium, inorganic phosphate and hemoglobin, and Kt/V did not differ between two groups. After 6 months, Kappa FLCs (from 354.4±509.7 to 304.7±401.8 mg/L, vs. from 236.7±73.8 to 248.2±73.8 mg/L ; p = 0.016), lambda FLCs (from 204.9±60.3 to 183.4.3±57.8 mg/L, vs. from 190.1±52.0 to 198.8±79.4 mg/L; p = 0.001), and beta-2 microglobulin levels (from 29.5±5.8 to 25.6±3.4 mcg/mL, vs. from 26.9±5.7 to 26.4±5.2 mcg/mL; p = 0.019) of MCO dialyzer group were significantly decreased, and while those of high-flux group were increased. The reduction ratios of kappa and lambda FLCs, and beta-2 microglobulin in MCO group were higher than those of high-flux group (10.5 vs. -5.3%, 11.1 vs. -3%, and 10.6 vs. -1%, respectively). After 6 months, there was no change in serum albumin levels between two groups.


Hemodialysis with MCO dialyzer shows better removal of FLCs, with preserved dialysis adequacy and serum albumin. Further studies are needed to establish the long-term effects of using MCO dialyzer on clinical outcome.