ArticleFrontiers in medicine2026
Improving immune function and mitochondrial health in patients undergoing hemodialysis: benefits of combining high-flux dialysis with hemoperfusion.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
Objective: This study aimed to investigate the effects of combining hemoperfusion (HP) with high-flux hemodialysis (HFD) on T lymphocyte subsets, mitochondrial health, and clinical outcomes in patients undergoing maintenance hemodialysis (MHD). Methods: In this single-center, prospective, self-controlled trial, 20 MHD patients received their regular HFD treatment, with the addition of a single HP session every 2 weeks for 12 sessions. Levels of protein-bound uremic toxins (PBUTs: indoxyl sulphate [IS] and p-cresyl sulphate [PCS]), T lymphocyte subsets (CD3+, CD4+, CD8+), mitochondrial membrane potential (MMP) in T cells, and patient-reported outcomes (SF-36, PSQI, pruritus scale) were assessed before and after the 12 sessions intervention. Results: Following a single HP + HFD session, IS and PCS levels decreased significantly ( Conclusion: After 12 sessions of combined hemoperfusion and high-flux dialysis, we observed significant increases in T lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8 + ratio) and the percentage of T cells with preserved mitochondrial membrane potential. Patients also reported improved sleep quality, reduced pruritus, and better quality of life. However, pre-dialysis levels of protein-bound uremic toxins (indoxyl sulphate and p-cresyl sulphate) of last session were not significantly different from baseline, despite effective clearance immediately after each combined session. Therefore, the observed improvements in immune-related parameters cannot be mechanistically attributed to a sustained reduction in these toxins. Alternative explanations-such as intermittent attenuation of peak toxin concentrations, clearance of unmeasured solutes, or non-specific effects-remain possible. Given the single-arm, observational design, these findings are hypothesis-generating and require confirmation in randomized controlled trials.
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