LAUSR

BACKGROUND Haemodialysis (HD) techniques that best remove molecules in the middle to high molecular weight range are on-line hemodiafiltration (OL-HDF) and HD with medium cut-off (MCO) membranes. The aim of this study was to compare efficacy and safety of OL-HDF with FxCordiax HDF 800TM , with HD with 2 MCO dialysers: Theranova 500® and the new Elisio21 HXTM dialyser. METHODS Fourteen patients following treatment with OL-HDF using FxCordiax HDF 800TM were randomised to receive a consecutive 1-week HD treatment with Theranova 500® and Elisio 21HXTM .The reduction rate (RR) of differently sized molecules was compared, as well as the variation rate in molecules smaller than 1000 , detected by nuclear magnetic resonance based chemometrics (metabolomics). Albumin loss in dialysate was quantified. RESULTS Lower RRs were found for molecules around 20,000 with Elisio 21HXTM compared to OL- HDF (RR prolactin 58.5% versus 66.7%, P=0.034; RR Kappa light chain 63.1% versus 71.8%, P=0.010). Albumin loss per session was higher with Theranova 500® than with OL-HDF and with Elisio 21HXTM (2249.9±714.1 mg, 815.2 ±474.0 mg, 442.9±135.9 mg, P<0.001, respectively). Metabolomic studies suggested, by semi-quantitative analysis, a greater depurative capacity of OL-HDF, followed by Elisio 21HXTM , and then Theranova 500®. CONCLUSIONS In this study, HD with Theranova 500® has proven to be very similar in efficacy to OL-HDF, although with a significantly higher albumin loss. HD with Elisio21HXTM resulted in lower removal of molecules around 20,000 compared to OL-HDF, with no significant difference compared to Theranova 500®, and with less albumin loss than Theranova 500®.