The efficiency of a novel asymmetrical cellulose triacetate dialysis membrane compared to a standard high-flux dialysis membrane; a pilot study.

Abstract

Aim: To compare properties of a novel asymmetrical cellulose triacetate (ATA) dialyser (Solacia 190-H, Nipro) to a commonly used high-flux polysulfone dialyser (FX-80, Fresenius) in patients undergoing long-hour (>7 hours) haemodialysis (HD). Background(s): The ATA membrane is highly porous and less prone to performance degradation, compared to a conventional high-flux membrane, potentially resulting in enhanced clearance of middle and large-middle molecules, along with protein bound solutes. Method(s): 10 long-hour home HD patients were included in this randomized cross-over trial. Patients were randomized to 4 weeks of either the 190-H or FX-80 dialyser with subsequent cross-over to the other. The removal of small (urea, phosphate and creatinine), middle and large-middle molecules (beta-2 microglobulin [B2M], indoxyl sulfate [IS], albumin) and markers of inflammation (interleukin-6 [IL-6], malondialdehyde-modified low density lipoprotein [MDA-LDL]), were evaluated during the mid-week dialysis session of the fourth week of each dialyser sequence. All results are expressed as mean differences in corresponding reduction ratios (RR) between the FX-80 and 190-H dialysers after 8 hours of dialysis. Result(s): There was no significant difference in reduction in clearance of small molecules, with a RR difference for urea -2.43 (p = 0.19), creatinine -1.82 (p = 0.28) and phosphate -2.61 (p = 0.55). Similarly, there was no difference in clearance of middle and large-middle molecules with a RR difference for B2M 2.63 (p = 0.22), IS 2.48 (p = 0.69) and albumin -0.15 (p = 0.96). There was also no difference in expression of inflammatory markers with RR for IL-6 18.8 (p = 0.44) and MDA-LDL -8.0 (p = 0.3). Conclusion(s): Our study did not demonstrate a difference in clearance of small, middle and large-middle molecules, nor the expression of markers of inflammation between the FX-80 and H-190 dialysers.