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Review

Medium Cut-Off Dialysis Membrane and Dietary Fiber Effects on Inflammation and Protein-Bound Uremic Toxins: A Systematic Review and Protocol for an Interventional Study

1
Department of Nephrology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
2
Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
*
Author to whom correspondence should be addressed.
Both authors contributed equally to this work.
Toxins 2021, 13(4), 244; https://doi.org/10.3390/toxins13040244
Received: 30 November 2020 / Revised: 22 March 2021 / Accepted: 25 March 2021 / Published: 29 March 2021
(This article belongs to the Special Issue New Strategies for the Reduction of Uremic Toxins)
The aim of this systematic review is to investigate the effects of the use of a medium cut-off membrane (MCO) and dietary fiber on the concentration of protein-bound uremic toxins (PBUTs) and inflammatory markers in hemodialysis (HD) patients. Of 11,397 papers originally found, eight met the criteria of randomized controlled trial design. No study examined the effects of MCO membranes on PBUTs. Three studies examined the reduction in inflammatory markers with MCO membranes compared to high-flux HD membranes and showed no significant differences. Five studies of dietary fiber supplementation showed an inconclusive positive effect on PBUT levels and a significant positive effect on the reduction in inflammatory markers (interleukin-6 reduction: standardized difference in means −1.18; 95% confidence interval −1.45 to −0.9 for dietary fiber supplementation vs. control; p < 0.001). To date, no study has combined the use of an MCO membrane and fiber supplementation to reduce PBUT levels and inflammation with online hemodiafiltration as a comparator. A rationale and protocol for an interventional trial using a combination of MCO membrane dialysis and fiber supplementation to lower inflammatory markers and PBUT concentrations are presented. View Full-Text
Keywords: protein-bound uremic toxins; p-cresyl sulfate; indoxyl sulfate; inflammation; IL-6; medium cut-off membrane; dietary fiber supplementation protein-bound uremic toxins; p-cresyl sulfate; indoxyl sulfate; inflammation; IL-6; medium cut-off membrane; dietary fiber supplementation
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MDPI and ACS Style

Herič, T.; Vivoda, T.; Bogataj, Š.; Pajek, J. Medium Cut-Off Dialysis Membrane and Dietary Fiber Effects on Inflammation and Protein-Bound Uremic Toxins: A Systematic Review and Protocol for an Interventional Study. Toxins 2021, 13, 244. https://doi.org/10.3390/toxins13040244

AMA Style

Herič T, Vivoda T, Bogataj Š, Pajek J. Medium Cut-Off Dialysis Membrane and Dietary Fiber Effects on Inflammation and Protein-Bound Uremic Toxins: A Systematic Review and Protocol for an Interventional Study. Toxins. 2021; 13(4):244. https://doi.org/10.3390/toxins13040244

Chicago/Turabian Style

Herič, Tjaša, Tjaša Vivoda, Špela Bogataj, and Jernej Pajek. 2021. "Medium Cut-Off Dialysis Membrane and Dietary Fiber Effects on Inflammation and Protein-Bound Uremic Toxins: A Systematic Review and Protocol for an Interventional Study" Toxins 13, no. 4: 244. https://doi.org/10.3390/toxins13040244

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