两种中高通量透析器的临床性能比较。

Clinical performance comparison of two medium cut-off dialyzers.

机构信息

Division of Nephrology, University Hospital Würzburg, Würzburg, Germany.

eXcorLab GmbH, Obernburg, Germany.

出版信息

Ther Apher Dial. 2023 Apr;27(2):284-292. doi: 10.1111/1744-9987.13919. Epub 2022 Aug 16.

DOI:10.1111/1744-9987.13919

PMID:36858049

Abstract

INTRODUCTION

Medium-cut-off (MCO) dialyzers may beneficially impact outcomes in patients on hemodialysis.

METHODS

In a randomized, controlled trial in maintenance hemodialysis patients, the new Nipro ELISIO-17HX MCO dialyzer was compared to the Baxter Theranova 400 filter regarding middle molecule removal. Furthermore, the suitability of two assays for free lambda-light chain (λFLC) detection (Freelite vs. N-Latex) was verified.

RESULTS

ELISIO-HX achieved slightly lower reduction ratios for β -microglobulin (71.8 ± 6.0 vs. 75.3 ± 5.8%; p = 0.001), myoglobin (54.7 ± 8.6 vs. 64.9 ± 8.7%; p < 0.001), and kappa-FLC (62.1 ± 8.8 vs. 56.3 ± 7.7%; p = 0.021). λFLC reduction ratios were more conclusive with the Freelite assay and not different between ELISIO-HX and Theranova (28.4 ± 3.9 vs. 38.7 ± 13.4%; p = 0.069). The albumin loss of Theranova was considerably higher (2.14 ± 0.45 vs. 0.77 ± 0.25 g; p = 0.001) and the Global Removal Score largely inferior (30.6 ± 7.4 vs. 82.4 ± 29.2%/g; p = 0.006) to ELISIO-HX.

CONCLUSIONS

The new ELISIO-HX expands the choice of dialyzers for MCO hemodialysis.

摘要

简介

中截留（MCO）透析器可能有益于血液透析患者的结局。

方法

在维持性血液透析患者的随机对照试验中，新型尼普洛 ELISIO-17HX MCO 透析器与百特 Theranova 400 滤器在中分子清除方面进行了比较。此外，还验证了两种游离 λ-轻链（λFLC）检测试剂盒（Freelite 与 N-Latex）的适用性。

结果

ELISIO-HX 对β-微球蛋白（71.8±6.0 比 75.3±5.8%；p=0.001）、肌红蛋白（54.7±8.6 比 64.9±8.7%；p<0.001）和 κ-轻链（62.1±8.8 比 56.3±7.7%；p=0.021）的清除率稍低。Freelite 检测试剂盒对 λFLC 清除率的检测结果更具说服力，ELISIO-HX 与 Theranova 之间无差异（28.4±3.9 比 38.7±13.4%；p=0.069）。Theranova 的白蛋白丢失量明显更高（2.14±0.45 比 0.77±0.25g；p=0.001），全球清除评分也明显较低（30.6±7.4 比 82.4±29.2%/g；p=0.006）。