Long-term effect of medium cut-off dialyzer on middle uremic toxins and cell-free hemoglobinopen access
- Authors
- Cho, Nam-Jun; Park, Samel; Islam, Md Imtiazul; Song, Ho-Yeon; Lee, Eun Young; Gil, Hyo-Wook
- Issue Date
- 26-Jul-2019
- Publisher
- Public Library of Science
- Keywords
- MCO
- Citation
- PLoS ONE, v.14, no.7
- Journal Title
- PLoS ONE
- Volume
- 14
- Number
- 7
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/4374
- DOI
- 10.1371/journal.pone.0220448
- ISSN
- 1932-6203
- Abstract
- The medium cut-off (MCO) dialyzer has shown good clearance of large middle molecules, but its long-term effects are unclear. We investigated whether MCO hemodialysis (HD) over one year could reduce middle molecule levels and cell-free hemoglobin (CFH), without albumin loss. A prospective cohort study in 57 hemodialysis patients was conducted. The patients were assigned to the MCO dialyzer group or the high-flux dialyzer group, according to the HD machine they used. The reduction ratio (RR) and one-year changes in small and middle molecules and CFH were analyzed. Over a 12-month follow-up, MCO HD did not reduce the serum levels of middle molecules (lambda free light chain [FLC], from 135.7 +/- 39.9 to 132.0 +/- 39.1 mg/L; kappa FLC, from 168.2 +/- 58.5 to 167.7 +/- 65.8 mg/L; beta 2-microglobulin, from 25.6 +/- 9.6 to 28.4 +/- 4.8 mg/L) or albumin (from 3.96 +/- 0.31 to 3.94 +/- 0.37 g/dL). MCO HD provided excellent RR of lambda FLC (49.3 +/- 10.3%), kappa FLC (69.6 +/- 10.4%) and beta 2-microglobulin (80.9 +/- 7.3%), compared to high-flux HD. CFH was also removed well during an MCO HD session (RR of CPH, 85.5 [78.7-97.3] %), but long-term change was not significant (from 57.8 [46.2-79.1] to 62.0 [54.6-116.7] mg/L). The MCO dialyzer can be used effectively and safely in conventional HD settings, but long-term effects on large middle molecules and CFH were not significant. Further studies are needed to verify clinical benefits of the MCO dialyzer.
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Collections - College of Medicine > Department of Microbiology > 1. Journal Articles
- College of Medicine > Department of Internal Medicine > 1. Journal Articles
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