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Abstract: FR-PO0500

Twelve-Month Evaluation of Middle Molecule (MMUT) and Protein-Bound Uremic Toxin (PBUT) Removal with Two Different Hemodiafiltration Filters

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Morisi, Niccolò, Universita degli Studi di Modena e Reggio Emilia, Modena, Emilia-Romagna, Italy
  • Ferrarini, Marco, Universita degli Studi di Modena e Reggio Emilia, Modena, Emilia-Romagna, Italy
  • Giovanella, Silvia, Universita degli Studi di Modena e Reggio Emilia, Modena, Emilia-Romagna, Italy
  • Ligabue, Giulia, Universita degli Studi di Modena e Reggio Emilia, Modena, Emilia-Romagna, Italy
  • Troise, Dario, Universita degli Studi di Foggia, Foggia, Apulia, Italy
  • Stallone, Giovanni, Universita degli Studi di Foggia, Foggia, Apulia, Italy
  • Donati, Gabriele, Universita degli Studi di Modena e Reggio Emilia, Modena, Emilia-Romagna, Italy
Background

The CHORALS study is designed to compare ATA versus PS membranes in postdilutional high volume hemodiafiltration (HDF), evaluating their relative efficacy in reducing plasma levels of MMUTs and PBUTs both within single dialysis sessions and over a 12 month treatment period.

Methods

Twenty anuric haemodialysis (HD) patients were enrolled either in ATA arm or PS arm. Intradialytic reduction ratio (RR) were calculated at the start of the study (T0) and after 6 months (T6) for each tested molecule. Blood concentration was monitored each month for B2 Microglobulin (B2M), k free light chain (Lk), λ free light chain (Lλ), P-Cresyl (PC) and Indoxil Sulphate (IS). Data corrected by hemoconcentration were analyzed through t-test or nonparametric analogue.

Results

No significant RR differences were found except for Lk, in which the PS membrane performs better than ATA (T0 p=0.0044, T6 p=0.0163). No difference in Lk levels was found in the 12-mont follow up. During the 12-month follow up no significant variation was found except for the B2M concentration growth in PS arm (p=0.0039).

Conclusion

The data show a significant reduction in serum MMUTs and PBUTs by more than 50% during a single session of HDF, with high reproducibility between sessions. As long-term blood concentration does not decrease significantly during the follow-up, we speculate that toxin production fluctuations and the presence of other compartments stockpiling molecules are involved. Nevertheless, MMUT and PBUT seems to be not significantly affected by the use of ATA or PS membranes in HDF in the present study.

Digital Object Identifier (DOI)