Comparison of Hemodialysis Using a Medium Cutoff Dialyzer versus Hemodiafiltration: A Controlled Cross-Over Study

Figures & data

Table 1 Description of the Patients (n=16)

		N (%)
Cause of CKD (Chronic Kidney Disease)	Diabetes	7 (44%)
	Polycystic kidney disease	2 (12.5%)
	Other	7 (44%)
Vascular access	AV-fistula	15 (94%)
	Central venous dialysis catheter	1 (6%)
Urine production	Anuric	11 (69%)
	700–3000 mL	5 (31%)
		Mean ± SD (range)
Age (years)		59.6±12.9 (34–81)
Dialysis vintage (years)^a		4.9±4 (1–13)

Note: ^aDialysis vintage is only approximate.

Table 2 Description of the Renal Replacement Therapy (n=16)

	ol-HDF	MCO-HD
	Mean ± SD	Mean ± SD
Blood flow mL/min (at 30 min)	324±9.6	323±10.8
Dialysate flow mL/min	550±0	547±12.5
UF rate (L/h)	0.62±0.29	0.64±0.34
Convection volume	24.5±3.5 range:(16.9–30.6)	-
Hematocrit initial, A0	0.333±0.046	0.329±0.046
Dialyzer	Polyflux 210H	Theranova 500

Table 3 Description of Pre- and Post-Dialysis Concentrations, and Reduction Ratios During Dialysis with MCO-HD (Theranova) vs HDF (Polyflux 210H)

	Pre-Dialysis Concentration		Post-Dialysis Concentration^a		Reduction Ratio
	Mean [A0]		Mean [A240]		RR, Mean ± SD
Small	HDF	MCO	HDF	MCO	HDF	MCO	∆ RR	p-val
Urea (mmol/L)	18.9	18.6	5.51	5.23	71.8 ±7.1	72.6 ±7.8	−0.78 ±2.2	0.19
Creatinine (µmol/L)	791	794	277	276	64.7 ±7.9	65.2 ±7.5	−0.43 ±2.1	0.44
Phosphate (mmol/L)	1.57	1.49	0.667	0.619	55.8 ±11	55.2 ±14	0.58 ±14	0.87
Middle^a
β2-microglobulin (mg/L)	24.8	25.6	7.25	7.85	70.6 ±8.5	68.5 ±10	2.10 ±4.2	0.061
Cystatin C (mg/L)	6.94	7.02	2.21	2.38	68.1 ±7.7	65.8 ±8.0	2.38 ±2.7	0.0030**
Myoglobin (µg/L)	209	203	91.1	91.6	56.2 ±10.6	54.0 ±9.3	2.11 ±5.4	0.14
Beta-Trace (mg/L)	7.72	7.79	4.69	4.87	38.4 ±13	35.5 ±12	2.91 ±12	0.34
Troponin T (ng/L)	79.9	79.4	53.7	53.5	34.2 ±10	34.0 ±8.2	0.177 ±7.4	0.93
Large/mixed^a
Albumin (g/L)	34.8	34.2	36.2	34.9	−3.71±5.2	−2.02 ±3.9	−1.69 ±7.1	0.37
Transferrin (g/L)	1.56	1.56	1.63	1.61	−3.80 ±4.8	−2.61 ±4.3	−1.18 ±5.9	0.43
IgG (g/L)	10.7	10.4	11.0	10.8	−3.38 ±5.6	−3.92 ±4.2	0.539 ±6.0	0.73
Transthyretin (Prealbumin) (g/L)	0.316	0.320	0.337	0.312	−7.88 ±18	0.359 ±17	−8.23 ±23	0.17
Total protein (g/L)	63.6	63.1	65.3	64.0	−2.65 ±5.5	−1.24 ±4.1	−1.41 ±4.9	0.30
EVF	0.333	0.329	0.349	0.348	−4.88 ±5.4	−5.79 ±6.4	0.91 ±6.1	0.56

Notes: [A0] = Concentrations at the dialysis inlet, at time 0. [A240] = Concentrations at the dialysis inlet, at time 240. ^aPost-dialysis concentrations of middle and large molecules are adjusted for hematocrit according to Schneiditz et al. ∆RR = Difference between RRs (HDF-MCO). **Significant using the Bonferroni-corrected threshold for 14 outcomes, p=0.0036.

Figure 1 Convection volume during HDF in relation to RR for HDF.

Figure 2 Convection volume during HDF in relation to ∆ RR.