Villacorta Linaza Blanca, Román Cabezas Mario, Sánchez-Pozo María Cristina, Alcaide Lara María Paz, Cabra-Rodríguez Rocío, Toro Prieto Francisco Javier
Departamento de Nefrología, Hospital Universitario Virgen del Rocío, Av. Manuel Siurot s/n, 41013 Seville, Spain.
Departamento de Bioquímica Clínica, Hospital Universitario Virgen del Rocío, Av. Manuel Siurot s/n, 41013 Seville, Spain.
Life (Basel). 2025 Apr 3;15(4):596. doi: 10.3390/life15040596.
As chronic kidney disease (CKD) prevalence rises, optimizing hemodialysis remains essential. While online hemodiafiltration (OL-HDF) is the gold standard, expanded hemodialysis (HDx), i.e., using high-performance dialyzers in standard hemodialysis, remains the most common clinical practice. Medium cutoff (MCO) membranes aim to enhance middle-molecule removal while preserving protein selectivity, although most studies evaluate them in OL-HDF. To this end, this study aims to compare the Xevonta-Hi (B. Braun), a high-flux (HF) polysulfone dialyzer, and the ELISIO-HX (Nipro), an MCO polyethersulfone dialyzer, in standard hemodialysis. In a prospective, observational study, seven stable patients sequentially received treatment with each dialyzer over four weeks. Pre- and post-dialysis levels of small and middle uremic molecules and inflammatory markers-including procalcitonin, prolactin, serum amyloid A, placental growth factor, interleukin-6, haptoglobin, ceruloplasmin, transferrin, prealbumin, and C-reactive protein-were measured. Both dialyzers demonstrated excellent clearance of small and middle molecules, with no significant differences in efficacy. Albumin and total protein losses remained minimal. Moderate reductions in serum amyloid A, placental growth factor, and interleukin-6 were observed, while no significant reductions occurred in the remaining inflammatory markers. These findings support the safety and effectiveness of both MCO and HF dialyzers in standard hemodialysis.
随着慢性肾脏病（CKD）患病率的上升，优化血液透析仍然至关重要。虽然在线血液透析滤过（OL-HDF）是金标准，但扩展血液透析（HDx），即在标准血液透析中使用高性能透析器，仍然是最常见的临床实践。中截流（MCO）膜旨在增强中分子清除率，同时保持蛋白质选择性，尽管大多数研究是在OL-HDF中对其进行评估的。为此，本研究旨在比较标准血液透析中高通量（HF）聚砜透析器Xevonta-Hi（贝朗公司）和MCO聚醚砜透析器ELISIO-HX（日机装公司）。在一项前瞻性观察研究中，7名病情稳定的患者在4周内依次接受了每种透析器的治疗。测量了透析前和透析后小和中尿毒症分子以及炎症标志物的水平，包括降钙素原、催乳素、血清淀粉样蛋白A、胎盘生长因子、白细胞介素-6、触珠蛋白、铜蓝蛋白、转铁蛋白、前白蛋白和C反应蛋白。两种透析器对小分子和中分子均显示出优异的清除率，疗效无显著差异。白蛋白和总蛋白损失保持在最低水平。观察到血清淀粉样蛋白A、胎盘生长因子和白细胞介素-6有适度降低，而其余炎症标志物无显著降低。这些发现支持了MCO和HF透析器在标准血液透析中的安全性和有效性。
