Anti-inflammatory effect of high flux dialyzer surface area 2.6m2 in high flux hemodialysis and hemodiafiltration.

ABSTRACT

Dialysis therapy has remarkably evolved through the innovation in dialyzers and hemodialysis modalities, enhancing patients' quality of life. The efficacy of dialysis can be determined by measuring the reduction ratio (RR) of middle molecules such as Interleukin-6 (IL-6) and Procalcitonin. In our study, we tested a high-flux dialyzer, BIOPURE (Biorema) 260 HF, with a surface area (SA) of 2.6 m2, in terms of IL-6 and Procalcitonin removal while performing high-flux hemodialysis (HF-HD) and post-dilution online hemodiafiltration (OL-HDF). This crossover study comprised 25 patients who received a session of HF-HD using the BIOPURE (Biorema) 260 H, followed by a session of post-dilution OL-HDF. A washout period of 2 weeks was instilled between the two sessions, during which the patients received HF-HD using high-flux dialyzers (maximum SA 2.0 m2). All patients' pre/post dialysis concentrations of IL-6 and procalcitonin were measured. The dialyzer used in this study resulted in a significant IL-6 RR of 44.92±5.11% (p <0.001) with HDF and 32.48±5.72% (p <0.001) with HF-HD; and a procalcitonin RR of 50.32±3.94% (p <0.001) with HDF and 41.80±4.32% (p <0.001) with HF-HD. In conclusion, the dialyzer BIOPURE (Biorema) 260 HF (SA 2.6 m2) is efficient in eliminating IL-6 and procalcitonin, especially with OL-HDF compared to HF-HD, with acceptable albumin loss in the dialysate.