Medium cut-off dialyzer improves erythropoiesis stimulating agent resistance in a hepcidin-independent manner in maintenance hemodialysis patients: results from a randomized controlled trial

• Published in: Scientific reports 2020-09, Vol.10 (1), p.16062, Article 16062
• Main Authors: Lim, Jeong-Hoon, Jeon, Yena, Yook, Ju-Min, Choi, Soon-Youn, Jung, Hee-Yeon, Choi, Ji-Young, Park, Sun-Hee, Kim, Chan-Duck, Kim, Yong-Lim, Cho, Jang-Hee
• Format: Article
• Language: English
• Subjects: 692/4022; 692/4022/1585; 692/4022/1950; Aged; Anemia; C-Reactive Protein - metabolism; Erythropoiesis - drug effects; Erythropoietin - metabolism; Female; Hematinics - pharmacology; Hepcidins - metabolism; Hepcidins - pharmacology; Humanities and Social Sciences; Humans; Inflammation; Iron - metabolism; Kidney Failure, Chronic - blood; Kidney Failure, Chronic - physiopathology; Male; Middle Aged; multidisciplinary; Receptors, Transferrin - metabolism; Renal Dialysis - methods; Science; Science (multidisciplinary); Tumor Necrosis Factor-alpha - metabolism
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-020-73124-x

The response to erythropoiesis stimulating agents (ESAs) is affected by inflammation linked to middle molecules in hemodialysis (HD) patients. We evaluated the effect of a medium cut-off (MCO) dialyzer on ESA resistance in maintenance HD patients. Forty-nine patients who underwent high-flux HD were randomly allocated to the MCO or high-flux group. The primary outcome was the changes of erythropoietin resistance index (ERI; U/kg/wk/g/dL) between baseline and 12 weeks. The MCO group showed significant decrease in the ESA dose, weight-adjusted ESA dose, and ERI compared to the high-flux group at 12 weeks ( p