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首页> 外文期刊>Clinical kidney journal. >Evaluation of the efficacy of a medium cut-off dialyser and comparison with other high-flux dialysers in conventional haemodialysis and online haemodiafiltration
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Evaluation of the efficacy of a medium cut-off dialyser and comparison with other high-flux dialysers in conventional haemodialysis and online haemodiafiltration

机译：在常规血液透析和在线血液透析滤过中，评估中等截留透析器的功效并与其他高通量透析器进行比较

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Background Online haemodiafiltration (OL-HDF) has been shown to reduce all-cause mortality versus conventional haemodialysis (HD); however, it is not always available. In these situations, a novel class of membranes with a higher pore size, medium cut-off (MCO) dialysers, could be promising. The aim of this study is to evaluate the efficacy of an MCO dialyser in the removal of small and medium-size molecules and compare it with standard high-flux (HF) dialysers in HD and OL-HDF. Methods In this crossover study, 18 prevalent HD patients were studied in three single mid-week dialysis treatments during three consecutive weeks as follows: first week with OL-HDF with a standard HF dialyser, second week with conventional HD with a standard HF dialyser and third week with conventional HD with an MCO dialyser. Reduction ratios (RRs) of different-sized molecules and albumin losses were collected for the different dialysers. Results MCO HD provided a greater reduction of middle and larger middle molecules compared with standard HF HD [rate reduction (RR) β2-microglobulin 74.7% versus 69.7%, P=0.01; RR myoglobin 62.5% versus 34.3%, P=0.001; RR prolactin 60% versus 32.8%, P=0.001; RR α1-glycoprotein 2.8% versus ?0.1%, P=0.01]. We found no difference in the clearance of small and larger middle molecules comparing MCO HD with OL-HDF. Albumin losses were 0.03 g/session with MCO HD and 3.1 g/session with OL-HDF (P=0.001). Conclusion MCO HD is superior to standard HF HD in the removal of middle and larger middle molecules and it is not inferior to OL-HDF in the clearance of small and larger middle molecules. Thus it could be an alternative in patients in which it is not possible to perform OL-HDF.
机译：背景技术在线血液透析滤过（OL-HDF）已被证明与常规血液透析（HD）相比可降低全因死亡率;但是，它并不总是可用。在这些情况下，具有更高孔径，中等截留（MCO）透析器的新型膜可能是有希望的。这项研究的目的是评估MCO透析器在去除中小型分子方面的功效，并将其与HD和OL-HDF中的标准高通量（HF）透析器进行比较。方法在这项交叉研究中，对18位流行的HD患者进行了连续三周的三周单周透析治疗，研究如下：第一周使用OL-HDF和标准HF透析器，第二周使用常规HD并使用标准HF透析器和第三周使用MCO透析仪进行常规高清处理。针对不同的透析器收集不同大小的分子的还原率（RRs）和白蛋白损失。结果与标准HF HD相比，MCO HD提供了更大的中间分子和更大的中间分子[比率降低率（RR）β2-微球蛋白74.7％vs 69.7％，P = 0.01; RR肌红蛋白62.5％对34.3％，P = 0.001; RR催乳素60％对32.8％，P = 0.001; RRα1-糖蛋白2.8％相对于±0.1％，P = 0.01]。我们发现与MCO HD和OL-HDF相比，中小分子的清除率没有差异。使用MCO HD的白蛋白损失为0.03 g /疗程，使用OL-HDF的蛋白质为3.1 g /疗程（P = 0.001）。结论MCO HD在去除中，较大的中间分子方面优于标准的HF HD，并且在清除较小和较大的中分子方面不劣于OL-HDF。因此，对于无法进行OL-HDF的患者，它可能是一种替代选择。

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