LAUSR

Dear Editor, Protein energy wasting (PEW), defined as loss of muscle mass and fuel reserves of the body, is a frequent and deleterious complication in hemodialysis (HD) patients. Several factors, including inflammation, retention of middle molecule uremic toxins, and dialysis procedure contribute to PEW [1]. HD with medium cut-off (MCO) dialyzer has demonstrated efficient depuration of middle uremic toxins and reduced inflammation [2, 3], which may have beneficial effects on PEW. To test the hypothesis that MCO-HD may positively affect body composition and nutritional status in HD patients, as compared to high-flux (HF) HD, we performed a 12-month single-center retrospective pilot study. Patients were recruited from the cohort of 40 patients evenly distributed on MCO-HD and HF-HD in a previous randomized study [4] and then continued maintenance HD using the same dialyzer as allocated after randomization. Among these patients, 16 patients (8 on MCO-HD and 8 on HF-HD) receiving 4 h, thrice weekly HD sessions using bicarbonate and citrate-containing acetate-free ultrapure dialysate were retrospectively analyzed (Table 1). All had a minimum of 12 months of Table 1. Patient characteristics at baseline