Effect of a medium cut-off dialyzer on protein-bound uremic toxins and mineral metabolism markers in patients on hemodialysis

Mark K Tiong; Rathika Krishnasamy; Edward R Smith; Colin A Hutchison; Elizabeth G Ryan; Elaine M Pascoe; Carmel M Hawley; Tim D Hewitson; Meg J Jardine; Matthew A Roberts; Yeoungjee Cho; Muh Geot Wong; Anne Heath; Craig L Nelson; Shaundeep Sen; Peter F Mount; Liza A Vergara; Peta-Anne Paul-Brent; David W Johnson; Nigel D Toussaint

Journal article

Effect of a medium cut-off dialyzer on protein-bound uremic toxins and mineral metabolism markers in patients on hemodialysis

Mark K Tiong, Rathika Krishnasamy, Edward R Smith, Colin A Hutchison, Elizabeth G Ryan, Elaine M Pascoe, Carmel M Hawley, Tim D Hewitson, Meg J Jardine, Matthew A Roberts, Yeoungjee Cho, Muh Geot Wong, Anne Heath, Craig L Nelson, Shaundeep Sen, Peter F Mount, Liza A Vergara, Peta-Anne Paul-Brent, David W Johnson, Nigel D Toussaint

Hemodialysis International | WILEY | Published : 2021

DOI: 10.1111/hdi.12924

Abstract

INTRODUCTION: Hemodialysis (HD) with medium cut-off (MCO) dialyzers may expand molecular clearance, predominantly larger middle molecules (molecular weight 25-60 kDa). However, the impact of MCO dialyzers on long-term clearance of various other components of the uremic milieu is unknown. The tRial Evaluating Mid cut-Off Value membrane clearance of Albumin and Light chains in HemoDialysis patients (REMOVAL-HD) provided an opportunity to assess the effect of MCO dialyzers on protein-bound uremic toxins and novel markers of mineral metabolism. METHODS: This exploratory sub-study of REMOVAL-HD evaluated changes in protein-bound solutes (total and free indoxyl sulfate [IS] and p-cresyl sulfate [P..

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