Observational studyBMC nephrology2019
Removal of large middle molecules via haemodialysis with medium cut-off membranes at lower blood flow rates: an observational prospective study.
Observational study in BMC nephrology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
30 citing papers in PubMed, 2 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- Prevalence of metabolic syndrome in patients with end-stage renal disease: a systematic review and meta-analysis.International urology and nephrology · 2024Pooled it
- Efficacy and safety of expanded hemodialysis in hemodialysis patients: a meta-analysis and systematic review.Renal failure · 2022Pooled it
- Comparison of middle molecule removal with expanded hemodialysis versus haemodiafiltration among Chinese hemodialysis patients.Renal failure · 2025Trial
- Trial
- A randomized trial comparing medium cut-off membrane dialyzers with online hemodiafiltration for uremic toxins clearance in hemodialysis patients.Scientific reports · 2025Trial
- A Randomised Prospective Crossover Study on the Effects of Medium Cut-Off Membranes on FGF-23 and Inflammatory Mediators in Patients Receiving Regular Haemodialysis.Blood purification · 2025Trial
- Comparison of uremic toxin removal between expanded hemodialysis and high volume online hemodiafiltrations in different modes.Acta biochimica Polonica · 2024Trial
- Personalized Hemodialysis Approaches in Frail Older Individuals.Geriatrics (Basel, Switzerland) · 2026Review
- Clinical benefits and future directions of medium cut-off membranes in hemodialysis: a comprehensive review.The Korean journal of internal medicine · 2025Review
- Comparing Clearances of Polymethylmethacrylate and Polysulfone Dialyzer Membranes for Postdilution Hemodiafiltration in Patients With Kidney Failure: Protocol for a Systematic Review and Meta-Analysis.JMIR research protocols · 2025Article
- Medium cut-off dialyzer improves reduction ratios of large middle molecules associated with vascular calcification.Kidney research and clinical practice · 2024Article
- What is the final destination of hemodialysis membrane?Kidney research and clinical practice · 2024Article
- Article
- Hemodiafiltration versus Hemodialysis in End-Stage Kidney Disease: A Systematic Review and Meta-Analysis.Kidney medicine · 2024Article
- Latest Trends in Hemodiafiltration.Journal of clinical medicine · 2024Review
- Medium cut-off dialyzer for middle molecular uremic toxins in AKI and chronic dialysis.Journal of nephrology · 2024Review
- Trial design of the MOTheR HDx study: a multicenter, open-label, prospective, randomized study to explore the morbidity and mortality in patients dialyzed with the Theranova HDx in comparison with online hemodiafiltration.Clinical kidney journal · 2023Article
- Comparison of the medium cutoff dialyzer and postdilution hemodiafiltration on the removal of small and middle molecule uremic toxins.Kidney research and clinical practice · 2023Article
- Hemodiafiltration: Technical and Medical Insights.Bioengineering (Basel, Switzerland) · 2023Review
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOnline haemodiafiltration (OL-HDF) may improve middle molecular clearance in contrast to conventional haemodialysis (HD). However, OL-HDF requires higher convective flows and cannot sufficiently remove large middle molecules. This study evaluated the efficacy of a medium cut-off (MCO) dialyser in removing large middle molecular uraemic toxins and compared it with that of conventional high-flux (HF) dialysers in HD and predilution OL-HDF.
methodsSix clinically stable HD patients without residual renal function were investigated. Dialyser and treatment efficacies were examined during a single midweek treatment in three consecutive periods: 1) conventional HD using an HF dialyser, 2) OL-HDF using the same HF dialyser, and 3) conventional HD using an MCO dialyser. Treatment efficacy was assessed by calculating the reduction ratio (RR) for β2-microglobulin (β2M), myoglobin, κ and λ free light chains (FLCs), and fibroblast growth factor (FGF)-23 and measuring clearance for FLCs.
resultsAll three treatments showed comparable RRs for urea, phosphate, creatinine, and uric acid. MCO HD showed greater RRs for myoglobin and λFLC than did HF HD and predilution OL-HDF (myoglobin: 63.1 ± 5.3% vs. 43.5 ± 8.9% and 49.8 ± 7.3%; λFLC: 43.2 ± 5.6% vs. 26.8 ± 4.4% and 33.0 ± 9.2%, respectively; P < 0.001). Conversely, predilution OL-HDF showed the greatest RR for β2M, whereas MCO HD and HF HD showed comparable RRs for β2M (predilution OL-HDF vs. MCO HD: 80.1 ± 4.9% vs. 72.6 ± 3.8%, P = 0.01). There was no significant difference among MCO HD, HF HD, and predilution OL-HDF in the RRs for κFLC (63.2 ± 6.0%, 53.6 ± 15.5%, and 61.5 ± 7.0%, respectively; P = 0.37), and FGF-23 (55.5 ± 20.3%, 34.6 ± 13.1%, and 35.8 ± 23.2%, respectively; P = 0.13). Notably, MCO HD showed improved clearances for FLCs when compared to HF HD or OL-HDF.
conclusionsMCO HD showed significantly greater RR of large middle molecules and achieved improved clearance for FLCs than conventional HD and OL-HDF, without the need for large convection volumes or high blood flow rates. This would pose as an advantage for elderly HD patients with poor vascular access and HD patients without access to OL-HDF.
trial registrationClinical Research Information Service (CRIS): KCT 0003009. The trial was prospectively registered on the 21 Jul 2018.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.