부산대학교 도서관

Background. Dialyzers should be designed to efficiently eliminate uraemic toxins during dialysis treatment, given that the accumulation of small and middle molecular weight uraemic solutes is associated with increased mortality risk of patients with end-stage renal disease. In the present study we investigated the novel FX CorAL dialyzer with a modified membrane surface for performance during online hemodiafiltration (HDF) in a clinical setting. Methods. comPERFORM was a prospective, open, controlled, multicentric, interventional, crossover study with randomized treatment sequences. It randomized stable patients receiving regular post-dilution online HDF to FX CorAL 600 (Fresenius Medical Care Deutschland), xevonta Hi 15 (B. Braun) and ELISIO 150H (Nipro) each for 1 week. The primary outcome was [beta]2-m removal rate ([beta]2-m RR) during online HDF. Secondary endpoints were RR and/or clearance of [beta]2-m and other molecules. Albumin removal over time was an exploratory endpoint. Non-inferiority and superiority of FX CorAL 600 versus comparators were tested. Results. Fifty-two patients were included and analysed. FX CorAL 600 showed the highest [beta]2-m RR (75.47%), followed by xevonta Hi 15 (74.01%) and ELISIO 150H (72.70%). Superiority to its comparators was statistically significant (P = 0.0216 and P < 0.0001, respectively). Secondary endpoints related to middle molecules affirmed these results. FX CorAL 600 demonstrated the lowest albumin removal up to 60 minutes and its sieving properties changed less over time than with comparators. Conclusions. FX CorAL 600 efficiently removed middle and small molecules and was superior to the two comparators in [beta]2-m RR. Albumin sieving kinetics point to reduced formation of a secondary membrane. Keywords: albumin sieving, FX CorAL, hemodiafiltration, membrane design, performance
INTRODUCTION Uraemic solutes are removed from the blood of haemodialysis patients via a haemodialyzer. The dialyzer's membrane is mainly responsible for the selective sieving of molecules; the overall goal is [...]