Combining Diffusion, Convection and Absorption: A Pilot Study of Polymethylmethacrylate versus Polysulfone Membranes in the Removal of P-Cresyl Sulfate by Postdilution On-Line Hemodiafiltration

Dialytic clearance of p-cresyl sulfate (pCS) and other protein-bound toxins is limited by diffusive convective therapies, only a few studies have examined how to improve their removal adsorptive membranes. This study tested the hypothesis that high-flux polymethylmethacrylate (PMMA) dialysis membranes with capacity increase pCS compared polysulfone membranes, in postdilution on-line hemodiafiltration (OL-HDF) session. Thirty-five stable hemodialysis patients randomly completed single 4 h OL-HDF PMMA (BG2.1U, Toray®, Tokyo, Japan) (TS2.1, Toray®) The primary endpoint was serum reduction ratios (RRs) obtained each dialyzer. Secondary outcomes included RRs solutes such as β2-microglobulin, volume after session, dose estimated ionic dialysance (Kt) urea kinetics (Kt/V). for were higher membrane than those (88.9% vs. 58.9%; p < 0.001), whereas β2-microglobulin (67.5% 81.0%; Kt (60.2 ± 8.7 65.5 9.4 L; = 0.01), Kt/V (1.9 0.4 2.0 0.5; 0.03), convection (18.8 2.8 30.3 7.8 L/session; 0.001) significantly membrane. In conclusion, superior appearing be good strategy improving dialytic pCS, enabling an acceptable small solutes.