Akademik Veri Yönetim Sistemi
HEMODIALYSIS INTERNATIONAL, cilt.30, sa.1, ss.168-175, 2026 (SCI-Expanded, Scopus)
Background T50 is a serum-based measure of calcification propensity and a predictor of cardiovascular risk and mortality in hemodialysis (HD) patients. Cardiovascular disease is in part driven by uremic toxins. Medium cut-off (MCO) dialyzers enhance the clearance of middle molecular weight (MW) uremic toxins compared to conventional dialyzers. However, the long-term impact of MCO dialyzers on pre-dialysis and post-dialysis T50 scores remains unknown. Methods The study included maintenance HD patients on low-flux (LF) dialyzers. Pre- and post-dialysis serum samples were collected in mid-week HD sessions: first with LF dialyzers (baseline) and then 6 months after switching to MCO dialyzers. Change in T50 was analyzed for a single HD treatment under LF and MCO dialyzers, and baseline and sixth-month pre-dialysis T50 scores were compared. Results Fifteen patients were included. Pre- and post-dialysis percent improvement in T50 for LF and MCO dialyzers were similar (85.2% [45.0, 282.7] and 56.3% [21.1, 238.6], respectively, p = 0.35). Pre-dialysis T50 after 6 months on MCO was comparable to the baseline (p = 0.73). Pre-dialysis T50 at baseline had an inverse association with improvement in T50 after a single HD treatment (beta = -0.88; 95% CI: -1.18 to -0.57; p < 0.01), and smoking had a direct association with pre-dialysis T50 after 6 months of MCO treatment (beta = -172; 95% CI: -287 to -56.8; p = 0.02). Conclusion MCO dialyzers do not confer additional benefits in improving serum calcification propensity, compared to LF dialyzers. Our data do not support a significant contribution of middle MW uremic toxins' removal to T50 scores.