The Impact of Medium Cut-Off Dialyzers on Malnutrition-Inflammation Scores in Maintenance Hemodialysis Patients

Introduction: Medium cut-off (MCO) membranes may be able to remove middle-large uremic toxins that are retained in the body, which has been linked to various risk factors including malnutrition-inflammation score (MIS). The effect of MCO dialyzers on MIS have been studied. Methods: This single-center exploratory prospective observational study enrolled maintenance hemodialysis patients who underwent dialysis using either MCO (Theranova-400) or high-flux (FX80) membranes as part of their regular care. Measurements of MIS, body weight, height, BMI, and various biochemical markers were taken at the beginning and conclusion of the study. Results: This study included 50 patients who were treated with either the Theranova-400 (n=25) or the FX80 (n=25) for a period of six months. The two groups were similar in terms of demographics, duration of hemodialysis treatment, and baseline biochemical test results. Theranova-400 had no significant impact on the median MIS (6 [6-10] vs 7 [5-10], p 0.575) and serum albumin levels (4.07 [3.92-4.22] vs 4.04 [3.85-4.30], p 0.689), while the FX80 resulted in a significant increase in MIS (6 [5-8] vs 8 [6-10], p 0.033) and a significant decrease in serum albumin levels (4.23 [4.03-4.36] vs 3.98 [3.77-4.12], p 0.027) at the end of the study. Discussion/Conclusion: After six months of treatment, the MCO dialyzer did not demonstrate a statistically significant difference in the MIS when compared to the high-flux dialyzer. However, MIS worsening was significantly less in the MCO group, indicating the potential benefits of MCO membranes in maintaining nutritional status. Further research is required to validate these results.