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Abstract: SA-PO415

Evaluation of VIE-X Filter Performances vs. Medium Cut-Off Dialyzer and High-Flux Dialyzers on Protein Loss and Inflammatory Status of Chronic Hemodialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Marcello, Matteo, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
  • Lorenzin, Anna, Ospedale San Bortolo di Vicenza, Vicenza, Veneto, Italy
  • Ronco, Claudio, Ospedale San Bortolo di Vicenza, Vicenza, Veneto, Italy
  • Zanella, Monica, Ospedale San Bortolo di Vicenza, Vicenza, Veneto, Italy
Background

In ESKD there is retention of a wide range of uremic toxins. The identification middle molecular weight toxins, has promoted interest in the development of alternative techniques in order to remove larger solutes. Hemodiafiltration (HDF) has produced some results, although large convective volume, optimal vascular access and strict water quality management are required. A new class of membrane has been recently developed with a cut off (MWCO) close to the molecular weight of albumin and a very high retention onset (MWRO), allowing convective movement of large uremic solutes even in conventional HD. The aim of this study was to evaluate the safety and efficacy of ASAHI new membrane Vie-X, comparing its performance with MCO membranes and HDF treatments.

Methods

A longitudinal single-center device study was conducted for 3 months among 18 chronic HD patients afferents to our center. Patients were randomly assigned to either online HDF, HDx with MCO membrane, or HD with Asahi Vie-X. Blood samples, as well as dialytic effluent, were collected during 4 dialysis sessions (T0, T1, T2, T3). The primary goal was to assess albumin loss among the three types of dialyzers.

Results

All dialyzers had an albumin loss lower than 5 grams per HD session. We found a greater albumin loss in patients undergoing HD with MCO membrane with a significant difference in comparison to Vie-X and online HDF, p=0.003 (Figure 1). We didn't find any statistical difference in the clearance of middle molecules such as myoglobin between the three dialyzers (p=0.22). Clearance of Il-6 was higher in patients undergoing online HDF (p<0.001).

Conclusion

Vie-X is a polysulfone, vitamin E-interactive membrane with presumed cut-off valued of 60kD allowing advanced sieving profiles and increased internal filtration. In our study we find Vie-X to have a safe albumin loss, comparable to that of online HDF, maintaining clearance for middle molecular weight molecules similar to MCO dialyzer and online HDF.