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Membranes
Volume 12
Issue 5
10.3390/membranes12050443
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Systematic Review

Effects of Medium Cut-Off Polyarylethersulfone and Polyvinylpyrrolidone Blend Membrane Dialyzers in Hemodialysis Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

by
Yu-Hui Hung
1,
Tai-Shuan Lai
1,
Mohamed Belmouaz
2,
Ya-Chun Tu
1,
Chun-Fu Lai
1,*,
Shuei-Liong Lin
1,3 and
Yung-Ming Chen
1,4
1
Renal Division, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 112201, Taiwan
2
Department of Nephrology, Poitiers University Hospital, 86000 Poitiers, France
3
Graduate Institute of Physiology, National Taiwan University College of Medicine, Taipei 112201, Taiwan
4
Department of Geriatrics and Gerontology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 112201, Taiwan
*
Author to whom correspondence should be addressed.
Membranes 2022, 12(5), 443; https://doi.org/10.3390/membranes12050443
Submission received: 31 March 2022 / Revised: 15 April 2022 / Accepted: 15 April 2022 / Published: 20 April 2022
(This article belongs to the Special Issue Membranes in Biomedical Engineering: Assisting Clinical Engineers)
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Abstract

The use of medium cut-off (MCO) polyarylethersulfone and polyvinylpyrrolidone blend membrane is an emerging mode in hemodialysis. Recent studies have shown that MCO membranes exhibit a middle high molecular weight uremic toxin clearance superior to standard high flux hemodialysis. We conducted a systematic literature review and meta-analysis of randomized controlled trials to investigate whether MCO membranes efficiently increase the reduction ratio of middle molecules, and to explore the potential clinical applications of MCO membranes. We selected articles that compared beta 2-microglobulin (β2M), kappa free light chain (κFLC), lambda free light chain (λFLC), interleukin-6 (IL-6), and albumin levels among patients undergoing hemodialysis. Five randomized studies with 328 patients were included. The meta-analysis demonstrated a significantly higher reduction ratio of serum β2M (p < 0.0001), κFLC (p < 0.0001), and λFLC (p = 0.02) in the MCO group. No significant difference was found in serum IL-6 levels after hemodialysis. Albumin loss was observed in the MCO group (p = 0.04). In conclusion, this meta-analysis study demonstrated the MCO membranes’ superior ability to clear β2M, κFLC, and λFLC. Serum albumin loss is an issue and should be monitored. Further studies are expected to identify whether MCO membranes could significantly improve clinical outcomes and overall survival.
Keywords: artificial kidney; albumin; dialysis membrane expanded hemodialysis; beta 2-microglobulin; high retention onset; membrane characterization molecular weight; uremic toxin artificial kidney; albumin; dialysis membrane expanded hemodialysis; beta 2-microglobulin; high retention onset; membrane characterization molecular weight; uremic toxin

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MDPI and ACS Style

Hung, Y.-H.; Lai, T.-S.; Belmouaz, M.; Tu, Y.-C.; Lai, C.-F.; Lin, S.-L.; Chen, Y.-M. Effects of Medium Cut-Off Polyarylethersulfone and Polyvinylpyrrolidone Blend Membrane Dialyzers in Hemodialysis Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Membranes 2022, 12, 443. https://doi.org/10.3390/membranes12050443

AMA Style

Hung Y-H, Lai T-S, Belmouaz M, Tu Y-C, Lai C-F, Lin S-L, Chen Y-M. Effects of Medium Cut-Off Polyarylethersulfone and Polyvinylpyrrolidone Blend Membrane Dialyzers in Hemodialysis Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Membranes. 2022; 12(5):443. https://doi.org/10.3390/membranes12050443

Chicago/Turabian Style

Hung, Yu-Hui, Tai-Shuan Lai, Mohamed Belmouaz, Ya-Chun Tu, Chun-Fu Lai, Shuei-Liong Lin, and Yung-Ming Chen. 2022. "Effects of Medium Cut-Off Polyarylethersulfone and Polyvinylpyrrolidone Blend Membrane Dialyzers in Hemodialysis Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials" Membranes 12, no. 5: 443. https://doi.org/10.3390/membranes12050443

APA Style

Hung, Y.-H., Lai, T.-S., Belmouaz, M., Tu, Y.-C., Lai, C.-F., Lin, S.-L., & Chen, Y.-M. (2022). Effects of Medium Cut-Off Polyarylethersulfone and Polyvinylpyrrolidone Blend Membrane Dialyzers in Hemodialysis Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Membranes, 12(5), 443. https://doi.org/10.3390/membranes12050443

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