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Randomized Controlled Trial
. 2016 Dec;20(6):569-578.
doi: 10.1111/1744-9987.12454. Epub 2016 Aug 8.

A Prospective Multicenter Randomized Controlled Study on Interleukin-6 Removal and Induction by a new Hemodialyzer With Improved Biocompatibility in Hemodialysis Patients: A Pilot Study

Takatoshi Kakuta  1   2 , Hirotaka Komaba  2 , Nobuyoshi Takagi  3 , Yuichiro Takahashi  4 , Hajime Suzuki  2 , Toru Hyodo  5 , Mikako Nagaoka  6 , Reika Tanaka  7 , Soichiro Iwao  8 , Mari Ishida  1 , Hiroyuki Kobayashi  9 , Akira Saito  10 , Masafumi Fukagawa  2
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Randomized Controlled Trial

A Prospective Multicenter Randomized Controlled Study on Interleukin-6 Removal and Induction by a new Hemodialyzer With Improved Biocompatibility in Hemodialysis Patients: A Pilot Study

Takatoshi Kakuta et al. Ther Apher Dial. 2016 Dec.

Abstract

We compared interleukin-6 (IL-6) removal and induction between conventional polysulfone (Con) and TORAYLIGHT NV (NV) dialyzers in hemodialysis patients. Twenty patients on Con with high IL-6 concentrations (2.7-8.5 pg/mL) were randomized to Con or NV group. Dialyzer performance was determined in NV group while patients were on Con and after being switched onto NV. Erythropoiesis-stimulating agent (ESA) response index (ERI) was assessed every 4 months for one year. IL-6 clearance was comparable between Con and NV. IL-6 removal rates were comparable for the first 1 h, but were higher with NV for the entire session (P = 0.03). Before-to-during-dialysis IL-6 concentration ratios were lower with NV on the venous side after the session (P = 0.03). During the one-year study, hemoglobin was lower in Con group than in NV group at month 8 (P = 0.046). ERI decreased in NV and increased in Con group, with a significant difference between the groups (P = 0.002). NV and Con are comparable in removing IL-6 and both induce IL-6. However, the data suggest that NV induces less IL-6, which may reduce the risk of ESA hyporesponsiveness.

Keywords: Biocompatibility; Erythropoiesis stimulating agent; Hemodialysis; Inflammatory cytokine.

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