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논문분류	춘계학술대회 초록집
제목	Randomized controlled trial of medium cut-off or high-flux dialyzer on quality-of-life outcomes in maintenance hemodialysis patients
저자	Jeong-Hoon Lim, Hee-Yeon Jung, Ji-Young Choi, Sun-Hee Park, Chan-Duck Kim, Yong-Lim Kim, Jang-Hee Cho
출판정보	2019; 2019(1):
키워드	medium cut-off dialyzer \| middle-sized molecule \| quality of life \| hemodialysis
초록	Novel medium cut-off (MCO) dialyzer could remove middle-sized molecules known to be associated with variable subjective symptoms. However, there is no clinical data about patient-reported outcomes after using MCO dialyzer. We investigated the effect of MCO dialyzer on the improvement of quality of life in maintenance hemodialysis (HD) patients. In this randomized controlled trial, 50 HD patients with high-flux dialyzer for more than 3 months were assigned to either MCO or high-flux dialyzer. Kidney Disease Quality of Life Short Form 36 (KDQOL-36) and pruritus assessment using questionnaire and visual analog scale (VAS) were surveyed at baseline and 3 months after randomization. Reduction ratios of middle-sized molecules such as kappa and lambda free light chains (FLCs) were also evaluated. Two groups did not differ in laboratory markers including serum albumin at the baseline and follow-up period. Removal of kappa and lambda FLCs was significantly greater for MCO dialyzer than high-flux dialyzer (55.8 ± 15.7 % vs. 40.6 ± 14.6 %, p=0.001 and 56.1 ± 11.4 % vs. 42.5 ± 8.5 %, p<0.001). Patients with MCO dialyzer showed significantly higher scores at 3 months in the domain of physical functioning (75.2 ± 20.8 vs. 59.8 ± 30.1, p=0.042) and physical role (61.5 ± 37.6 vs. 39.0 ± 39.6, p=0.047) than patients with high-flux dialyzer. The mean scores of morning pruritus distribution (1.29 ± 0.46 vs. 1.64 ± 0.64, p=0.034) and frequency of scratching during sleep (0.25 ± 0.53 vs. 1.00 ± 1.47, p=0.023) were significantly lower in MCO group than high-flux group. MCO dialyzer improves patient-reported outcomes, especially physical component and uremic pruritus in the maintenance HD patients. HD using MCO dialyzer provides superior removal of kappa and lambda FLCs to high-flux HD. MCO dialyzer has non-significant effect on serum albumin concentration over 3 months of study duration. (Trial registration: cris.nih.go.kr, KCT0003026)
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