Chloé Bourguignon1, Leïla Chenine2, Anne Sophie Bargnoux1,3, Hélène Leray-Moragues2, Bernard Canaud4,5, Jean-Paul Cristol6,7,8,9, Marion Morena1,3,4. 1. Laboratoire de Biochimie-Hôpital Lapeyronie, CHRU Montpellier, 371, Avenue du Doyen Gaston Giraud, 34000, Montpellier, France. 2. Service de Néphrologie-Hémodialyse et Soins Intensifs, CHRU, 34000, Montpellier, France. 3. U1046 INSERM, UMR9214 CNRS Univ Montpellier, 34000, Montpellier, France. 4. Institut de Recherche et de Formation en Dialyse, CHRU Montpellier, 34000, Montpellier, France. 5. Université de Montpellier, 34000, Montpellier, France. 6. Laboratoire de Biochimie-Hôpital Lapeyronie, CHRU Montpellier, 371, Avenue du Doyen Gaston Giraud, 34000, Montpellier, France. jp-cristol@chu-montpellier.fr. 7. U1046 INSERM, UMR9214 CNRS Univ Montpellier, 34000, Montpellier, France. jp-cristol@chu-montpellier.fr. 8. Institut de Recherche et de Formation en Dialyse, CHRU Montpellier, 34000, Montpellier, France. jp-cristol@chu-montpellier.fr. 9. Université de Montpellier, 34000, Montpellier, France. jp-cristol@chu-montpellier.fr.
Abstract
BACKGROUND/AIMS: Serum free light chain (FLC) levels are correlated with chronic kidney disease (CKD) stages and are highest in patients on hemodialysis (HD). Aim of this study was to assess the FLC removal efficiency of Elisio™-210Hdialyzer using either high-flux HD or on line high efficiency hemodiafiltration (HDF) modalities in CKD-5D patients. METHODS: In this prospective and comparative study, 20 CKD-5D patients free from multiple myeloma were randomized in two groups: HD versus on line HDF. All patients were dialyzed with Elisio™-210H dialyzer. Serum samples were collected before and after the midweek dialysis session, before randomization and at the end of the study to measure κ and λ FLC concentrations. Reduction ratios were corrected for net ultrafiltration. RESULTS: For both HD and HDF mode, κ and λ FLC concentrations were significantly lower after dialysis than before but median reductions in κ and λ FLC levels were significantly higher in HDF versus HD groups (κ 73.5 vs. 65.5 %, p = 0.04 and λ 51.0 vs. 36.6 %, p = 0.07). After dialysis, all κ/λ ratio values were between 0.26 and 1.65 which is the reference range described in subjects with normal kidney function, for both HD and HDF groups (median κ/λ ratios were 0.80 [0.47-1.22] and 0.67 [0.50-0.79] respectively). CONCLUSION: This study shows the superiority of on line HDF compared with HD to remove both κ and λ FLC. Moreover, all post-dialysis κ/λ ratios reached normal reference range.
RCT Entities:
BACKGROUND/AIMS: Serum free light chain (FLC) levels are correlated with chronic kidney disease (CKD) stages and are highest in patients on hemodialysis (HD). Aim of this study was to assess the FLC removal efficiency of Elisio™-210H dialyzer using either high-flux HD or on line high efficiency hemodiafiltration (HDF) modalities in CKD-5D patients. METHODS: In this prospective and comparative study, 20 CKD-5D patients free from multiple myeloma were randomized in two groups: HD versus on line HDF. All patients were dialyzed with Elisio™-210H dialyzer. Serum samples were collected before and after the midweek dialysis session, before randomization and at the end of the study to measure κ and λ FLC concentrations. Reduction ratios were corrected for net ultrafiltration. RESULTS: For both HD and HDF mode, κ and λ FLC concentrations were significantly lower after dialysis than before but median reductions in κ and λ FLC levels were significantly higher in HDF versus HD groups (κ 73.5 vs. 65.5 %, p = 0.04 and λ 51.0 vs. 36.6 %, p = 0.07). After dialysis, all κ/λ ratio values were between 0.26 and 1.65 which is the reference range described in subjects with normal kidney function, for both HD and HDF groups (median κ/λ ratios were 0.80 [0.47-1.22] and 0.67 [0.50-0.79] respectively). CONCLUSION: This study shows the superiority of on line HDF compared with HD to remove both κ and λ FLC. Moreover, all post-dialysis κ/λ ratios reached normal reference range.
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