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-PO405

On the Removal of Middle Molecules and Albumin Loss: An Ex Vivo Evaluation of Commercial Dialyzers

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis


  • Hagemann, Franziska, Rheinisch-Westfalische Technische Hochschule Aachen, Aachen, Nordrhein-Westfalen, Germany
  • Roth, Hannah, Rheinisch-Westfalische Technische Hochschule Aachen, Aachen, Nordrhein-Westfalen, Germany
  • Linkhorst, John, Rheinisch-Westfalische Technische Hochschule Aachen, Aachen, Nordrhein-Westfalen, Germany
  • Wessling, Matthias, Rheinisch-Westfalische Technische Hochschule Aachen, Aachen, Nordrhein-Westfalen, Germany

An improved removal of middle-molecular-weight uremic toxins in hemodialysis treatments is essential for the patient’s health. Tailoring the membrane’s molecular weight cut off increases the removal of the toxins. However, an undesirable albumin loss is an often associated side effect and a potential concern for clinical use. A narrower pore size distribution counteracts the unwanted albumin loss. This study presents data on clearance and albumin loss at different blood and dialysate flow rates using novel dialyzers.


This study investigates the clearances for middle molecules in four commercial dialyzers with comparable surface areas. Simulated dialysis treatments were conducted using human plasma. The concentrations of the molecules were analyzed during 60min. The albumin loss was evaluated for 4h in a simulated hemodialysis treatment with bovine blood.


The size dependent clearance shows the same trend for all dialyzers. The larger the middle molecule the less the impact of increasing blood flow on clearance. Theranova achieves the most elevated clearance results for small and Phylther for large middle-molecules, cf. Tab 1. However, Phylther showed the highest albumin loss during a 4h treatment compared to the investigated dialyzers, cf. Tab 1.


Novel dialyzers with extended permeability enable the removal of middle molecules when used in chronic and acute settings. Phylther stands out with higher removal of the middle molecule YKL-40, compared to the other dialyzers but exhibits a significant albumin loss. Theranova demonstrates the best trade-off between low albumin loss and good clearances of middle molecules.

Tab 1: Clearance and albumin loss results
avs. Theranova bvs. Phylther cvs. Vitabrane; p < 0.05


  • Commercial Support –