Trial reportPloS one2019
Middle molecule clearance with high cut-off dialyzer versus high-flux dialyzer using continuous veno-venous hemodialysis with regional citrate anticoagulation: A prospective randomized controlled trial.
Trial report in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 46 citations in OpenAlex.
- Non-pharmacological interventions for preventing clotting of extracorporeal circuits during continuous renal replacement therapy.The Cochrane database of systematic reviews · 2021Pooled it
- Kidney REPLACEment therapies in patients with acute kidney injury and RHABDOmyolysis (ReplaceRhabdo): a pilot trial.BMC nephrology · 2025Trial
- Antibiotics Removal during Continuous Renal Replacement Therapy in Septic Shock Patients: Mixed Modality Versus "Expanded Haemodialysis".Clinical pharmacokinetics · 2024Trial
- A safe and effective protocol for postdilution hemofiltration with regional citrate anticoagulation.BMC nephrology · 2024Trial
- Myoglobin clearance with continuous veno-venous hemodialysis using high cutoff dialyzer versus continuous veno-venous hemodiafiltration using high-flux dialyzer: a prospective randomized controlled trial.Critical care (London, England) · 2020Trial
- Extracorporeal pediatric renal replacement therapy: diversifying application beyond kidney failure.Pediatric nephrology (Berlin, Germany) · 2025Review
- Kidney replacement and conservative therapies in rhabdomyolysis: a retrospective analysis.BMC nephrology · 2024Article
- Medium cut-off dialyzer for middle molecular uremic toxins in AKI and chronic dialysis.Journal of nephrology · 2024Review
- Use of extracorporeal therapies to treat life-threatening intoxications.Pediatric nephrology (Berlin, Germany) · 2024Review
- Liver replacement therapy with extracorporeal blood purification techniques current knowledge and future directions.World journal of clinical cases · 2023Review
- Clearance of inflammatory cytokines in patients with septic acute kidney injury during renal replacement therapy using the EMiC2 filter (Clic-AKI study).Critical care (London, England) · 2021Observational
- Use of the CytoSorb adsorption device in MDMA intoxication: a first-in-man application and in vitro study.Intensive care medicine experimental · 2020Article
- Application of extracorporeal therapies in critically ill COVID-19 patients.Journal of Zhejiang University. Science. BArticle
- Disruptive technologies for hemodialysis: medium and high cutoff membranes. Is the future now?Jornal brasileiro de nefrologiaArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRegional anticoagulation with citrate during renal replacement therapy (RRT) reduces the risk of bleeding, extends dialyzer lifespan and is cost-effective. Therefore, current guidelines recommend its use if patients are not anticoagulated for another reason and if there are no contraindications against citrate. RRT with regional citrate anticoagulation has been established in critically ill patients as continuous veno-venous hemodialysis (CVVHD) to reduce citrate load. However, CVVHD is inferior regarding middle molecule clearance compared to continuous veno-venous hemofiltration (CVVH). The use of a high cut-off dialyzer in CVVHD may thus present an option for middle molecule clearance similar to CVVH. This may allow combining the advantages of both techniques.
methodsIn this prospective, randomized, single-blinded single-center-trial, sixty patients with acute renal failure and established indication for renal replacement therapy were randomized 1:1 into two groups. The control group was put on CVVHD using regional citrate anticoagulation and a high-flux dialyzer, while the intervention group was on CVVHD using regional citrate anticoagulation and a high-cut-off dialyzer. The concentrations of urea, creatinine, β2-microglobulin, myoglobin, interleukin 6 and albumin were measured pre- and post-dialyzer 1, 6, 12, 24 and 48 hours after initiating CVVHD.
resultsMean plasma clearance for β2-microglobulin was 19.6±5.8 ml/min in the intervention group vs. 12.2±3.6 ml/min in the control group (p<0.001). For myoglobin (8.0±4.5 ml/min vs. 0.2±3.6 ml/min, p<0.001) and IL-6 (1.5±4.3 vs. -2.5±3.5 ml/min, p = 0.002) a higher mean plasma clearance using high-cut-off dialyzer could be detected too, but no difference for urea, creatinine and albumin could be observed concerning this parameter between the two groups.
conclusionCVVHD using a high cut-off dialyzer results in more effective middle molecule clearance than that with high-flux dialyzer.
trial registrationGerman Clinical Trials Register (DRKS00005254, registered 26th November 2013).
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Registered trials
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