Most recently developed polyester polymer alloy dialyzer: A new medium cut-off membrane?

BackgroundNew versions of the polyester polymer alloy (PEPA) membrane have appeared over the years, with increases in both the pore size and the amount of polyvinylpyrrolidone (PVP) to optimize hydrophilicity performance. This study aimed to assess the efficacy of the most recently developed PEPA dialyzer, the FDY series, in hemodialysis (HD) modality in terms of uremic toxin removal and albumin loss and to compare it with that of several high-flux dialyzers currently used in HD and post-dilution hemodiafiltration (HDF) treatments.MethodsA prospective study was carried out in 21 patients. All patients underwent six dialysis sessions with the same routine dialysis parameters; only the dialyzer and/or the dialysis modality varied: FX80 in HD, FDY 180 in HD, Clearum HS17 in HDF, Elisio 19H in HDF, Vitapes 180 in HDF, and FX80 in post-dilution HDF. The reduction ratios (RR) of urea, creatinine, ss2-microglobulin, myoglobin, kappa FLC, prolactin, alpha 1-microglobulin, alpha 1-acid glycoprotein, lambda FLC, and albumin were compared intraindividually. Dialysate albumin loss was also measured.ResultsBoth membranes FDY and FX80 are high-flux dialyzers and are applied here in high-flux HD. The average RR of beta 2-microglobulin was slightly lower in the two HD treatments than in the HDF treatments. Comparison of dialysis treatments revealed that the PEPA FDY dialyzer in the HD modality was more effective than the FX80 dialyzer in high-flux HD and was as effective as post-dilution HDF, especially in terms of myoglobin, kappa FLC, prolactin, alpha 1-microglobulin, and lambda FLC RRs. The FDY treatments obtained similar albumin RR in blood and slightly higher dialysate albumin loss, although the values were clinically acceptable.ConclusionsThe most recently developed PEPA dialyzers in the HD modality were as effective as all treatments in the HDF modality and were clearly superior to high-flux helixone HD treatment. These results confirm that this dialyzer should be categorized within the medium cut-off (MCO) membrane classification. Most recently developed PEPA dialyzers, FDY series, in HD modality, obtained similar efficacy to HDF treatments, and it was clearly superior over high-flux HD treatment. These results confirm that this dialyzer responds to the medium cut-off membrane classification. image