Abstracts Nephrology Dialysis Transplantation

CONCLUSIONS: SPAD is safe and efficient extracorporeal liver support system that
doesn’t require additional technology and could be easily used in treatment of patients
with LF in hospitals that are not equiped with other devices for albumin dialysis.
SP487 A 6-MONTH STUDY ON THE EFFICACY OF HEMODIALYSIS
THERAPY USING DIALYZERS WITH MEDIUM CUT-OFF
MEMBRANES IN ASIAN PATIENTS WITH END-STAGE RENAL
DISEASE
Jong Hwan Jung1, Ju Hung Song1, Seon-Ho Ahn1
1
Wonkwang University School of Medicine and Hospital, Iksan, Republic of Korea
start, 6.05 mg/L (range 5-7.01) at the end, p<0.05; C cystatin was 5.8 mg/L (range 4.2-
6.4) at dialysis start, 1.7 mg/L (range 1.2-1.9) at the end, p<0.05; PTH was 213.5 pg/mL
(range 129-380) at dialysis start, 116.2 pg/mL (range 96.4-326.7) at the end, p=ns; RBP
was 14.2 mg/dL (range 9.4-18.3) at dialysis start, 8.1 mg/dL (range 6.5-12.8) at the end,
p<0.05; kappa free light chains were 166.1 mg/L (range 114-315.2) at dialysis start, 71.5
mg/L (range 16.5-107) at the end, p<0.05; lambda free light chains was 107.3 mg/L
(range 58.5-138.1) at dialysis start, 58.2 mg/L (range 20.2-93.4) at the end, p<0.05.
Results from the second midweek session were the same. The reduction rate per session
are shown in the Figure. There was no clotting of the extracorporeal circuit. The anti-
Xa level was between 0.6-1.1 at 30’ only in 3 / 6 cases, while at the HD end was < 0.5 in
all cases.

INTRODUCTION: Medium cut-off (MCO) is a membrane with enhanced sieving

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properties. MCO membrane enabled improved clearance of larger middle molecules
through the internal filtration. A larger pore size and narrowed diameter of fibers
within MCO membrane could result in increase of internal filtration. Theoretically, the
enhanced pressure via internal filtration may increase clearance of several uremic
solutes and cause the leakage of albumin. We evaluated the efficacy and serological
change of chronic hemodialysis using dialyzer with MCO membrane.
METHODS: In this retrospectively longitudinal study, 42 patients undergoing
hemodialysis (HD) were analyzed for 6 months. The enrolled patients were on
hemodialysis treatment using dialyzer with high flux (HF) membrane for > 3 months
before enrolment. We divided enrolled patients into two groups. Patients in the control
group used dialyzer with HF membrane and patients in MCO group used MCO
membrane since enrolled point. The enrolled patients performed HD thrice a week. We
measured serum markers, including parathyroid hormone (PTH), C-reactive protein,
phosphate, total protein, and albumin at the points of baseline and 3-month and 6-
month. We calculated single-pool Kt/V (spKt/V) at all points.
RESULTS: Baseline characteristics, such as age, albumin, and phosphate showed
significant difference between two groups (p =0.018, p =0.003, and p =0.008,
respectively). In comparative analysis, there was no significant difference of all markers
between two groups. However, within MCO group, serum protein and albumin
showed a significantly decreasing tendency according to time (p <0.05), but serum
protein and albumin did not decrease statistically significant since 3 months from
baseline (p =0.472 and p =0.059, respectively). Also, within MCO group, serum PTH CONCLUSIONS: MCO-membrane can remove middle-sized molecules similar to
level decreased since 3 months from baseline (p =0.042). We also calculated spKt/V and hemodiafiltration treatments. Non significant albumin loss was observed.
the value did not also show significant difference between two group according to time Anticoagulation of the extracorporeal circuit with enoxaparin was effective and well
(baseline: p =0.849, 3-month: p=0.346, and 6-month: p =0.179, respectively). However, tolerated.
within MCO group, spKt/V value showed increasing tendency according to time (3-
month: p =0.006 and 6-month: p =0.025, respectively).
CONCLUSIONS: The baseline difference occurred because we chose the patients who
were young and well-nourished when we started using the MCO membrane. This made SP489 THE ROLE OF CA125 AS A VOLUME MARKER BEFORE AND
it difficult to analyze the comparison between the two groups at each point. However, AFTER HEMODIALYSIS SESSION
there was an initial loss of albumin while using the MCO membrane, but the long-term
use for more 3 months showed that albumin loss was not significant. We also Pablo Molina1, Alba Durba 1, Emma Calatayud1, Erika Pérez-Zafra1,
recognized that the use of MCO membrane for more 3 months may improve the Belén Vizcaıno1, Mercedes Gonza lez-Moya1, Sandra Beltra n1, Antonio Mora1,
adequacy of hemodialysis. The specific struction of MCO membrane can increase nica Escudero1, Nuria Estan
Vero ~1, Luis M Pallardo 1
internal filtration, which can eventually improve the removal of uremic solutes. 1
Hospital Universitari Dr Peset. Universitat de València, Valencia, Spain
Conclusively, when compared to hemodialysis using HF membrane, hemodialysis
using MCO membrane may be superior in clearance of small solutes and be not inferior INTRODUCTION: Accurate assessment of dry weight for maintaining an optimal
in albumin loss. fluid status is a cornerstone for the treatment of hemodialysis (HD) patients.
Carbohydrate antigen 125 (CA125), a tumor marker in ovarian malignancy, has
emerged as a surrogate of fluid overload and inflammatory status in heart failure
patients, but data in HD are lacking. This study investigated the relationship between
SP488 MIDDLE MOLECULES REMOVAL AND ANTICOAGULATION IN CA125 levels and volume status before and after HD session in a group of stable adult
HEMODIALYSIS WITH A MEDIUM CUT OFF MEMBRANE: HD patients, to determine whether CA125 is a reliable marker of volume status.
PRELIMINARY DATA FROM A MONOCENTRIC TRIAL METHODS: Prospective measurements of CA125 and brain natriuretic peptide (BNP)
and fluid volume by multifrequency bioimpedance spectroscopy (BIS) were conducted
Claudia Bini1, Gabriele Donati2, Elena Pelizzaro2, Anna Scrivo2, Anna Laura Croci before and after dialysis session in 48 stable maintenance HD patients (women: 40%;
Chiocchini2, Giacomo Magnoni2, Maria Mattiotti2, Federica Di Filippo2, mean age 64.5615.2 years; diabetes: 31%). CA125 and BNP measurements were
Gaetano La Manna2 assessed by automated immunoassay analyzer. Overhydration/ extracellular water
1
S.Orsola University Hospital, Bologna, Italy and 2S.Orsola University Hospital, Bologna (OH/ECW) ratio was used as fluid status index and OH/ECW ratio >0.15 was defined
Italy., Bologna, Metropolitan City of Bologna, Italy, Italy as clinical overhydration. Patients were divided into two groups: overhydrated (OH/
ECW>0.15) and non-overhydrated (OH/ECW0.15).
INTRODUCTION: A new type of medium cut-off (MCO) dialyzer has been RESULTS: OH/ECW ratio and the proportion of patients overhydrated were
developed, with a steeper pore distribution and a less risk of albumin loss. In our trial significantly reduced after HD session from 34% to 16% (p=0.031). A significant
we evaluated the MCO dialyzer permeability for larger middle molecules and the reduction in BNP levels was observed [579 (178-1216) Vs. 280 (88-725) pg/mL;
anticoagulation. p<0.001), whereas CA125 tended to increase from 21.8 (13.2-50.6) to 23.9 (13.5-50.6)
METHODS: Six HD chronic HD patients (age 37-85 years) were evaluated. All patients UI/mL (p=0.068) after HD session. OH/ECW was not correlated with CA125 nor BNP
underwent 4-hour HD session three times a week, for a total of 2 weeks, using the MCO levels. In addition, overhydrated patients did not show different CA125 and BNP levels
dialyzer TheranovaTM. Enoxaparin was used for anticoagulation. Serum samples were from those non-overhydrated.
collected during midweek sessions at the beginning and the the end of the treatment. CONCLUSIONS: Taken together, these data suggest that among HD patients CA125
Anti-Xa level was measures at the beginning of dialysis, after 30’ and at the end. and BNP are not reliable volume markers.
RESULTS: Median blood flow was 300 ml/min (range 250-330). During first midweek
session, albumin was 38.7 g/L (range 33.7-40.3) at dialysis start, 38.5 g/L (range 32.5-
40.8) at the end, p=ns. b2-microglobulin was 29.2 mg/L (range 21.5-32.8) at dialysis

i522 | Abstracts