Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea.
Department of Statistics, Kyungpook National University, Daegu, South Korea.
Sci Rep. 2020 May 8;10(1):7780. doi: 10.1038/s41598-020-64622-z.
Medium cut-off (MCO) dialyzers help remove larger middle molecules associated with symptoms related to the accumulation of uremic retention solutes. We investigated the effect of an MCO dialyzer on the improvement of quality of life (QOL) in maintenance hemodialysis (HD) patients. Forty-nine HD patients with high-flux dialysis were randomly assigned to either an MCO (Theranova 400, Baxter) or a high-flux (FX CorDiax 80 or 60, Fresenius Medical Care) dialyzer and completed the study. QOL was assessed at baseline and after 12 weeks of treatment using the Kidney Disease Quality of Life Short Form-36, and pruritus was assessed using a questionnaire and visual analog scale. The reduction ratios of middle molecules were also evaluated. Laboratory markers, including serum albumin, did not differ between the two groups after 12 weeks. Removals of kappa and lambda free light chains were greater for MCO dialyzer than high-flux dialyzer. The MCO group had higher scores than the high-flux group in the domains of physical functioning and physical role (75.2 ± 20.8 vs. 59.8 ± 30.1, P = 0.042; 61.5 ± 37.6 vs. 39.0 ± 39.6, P = 0.047, respectively), and the MCO group had lower mean scores for morning pruritus distribution and the frequency of scratching during sleep (1.29 ± 0.46 vs. 1.64 ± 0.64, P = 0.034; 0.25 ± 0.53 vs. 1.00 ± 1.47, P = 0.023, respectively). MCO dialyzers may improve patient-reported outcomes, particularly the physical components of QOL and uremic pruritus, in patients with high-flux dialyzers.
中分子截留（MCO）透析器有助于清除与尿毒症溶质蓄积相关的症状相关的较大的中间分子。我们研究了 MCO 透析器对维持性血液透析（HD）患者生活质量（QOL）改善的影响。49 名高通量透析的 HD 患者被随机分配到 MCO（Theranova 400，Baxter）或高通量（FX CorDiax 80 或 60，Fresenius Medical Care）透析器组，并完成了研究。在基线和治疗 12 周后使用肾脏病生活质量简表-36 评估 QOL，并使用问卷和视觉模拟量表评估瘙痒。还评估了中间分子的减少率。实验室标志物，包括血清白蛋白，在 12 周后两组之间没有差异。与高通量透析器相比，MCO 透析器对κ和λ游离轻链的清除率更高。MCO 组在身体功能和身体角色领域的得分高于高通量组（75.2±20.8 vs. 59.8±30.1，P=0.042；61.5±37.6 vs. 39.0±39.6，P=0.047，分别），MCO 组早晨瘙痒分布和睡眠时搔抓频率的平均得分较低（1.29±0.46 vs. 1.64±0.64，P=0.034；0.25±0.53 vs. 1.00±1.47，P=0.023，分别）。MCO 透析器可能会改善患者报告的结果，特别是高通量透析器患者的 QOL 和尿毒症瘙痒的身体成分。
