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Background <p>When increasing the reduction ratio (RR) of α<sub>1</sub>-microglobulin (α1MG) to improve symptoms, the dialysis dose is usually increased. However, no studies on its effectiveness have been reported.</p> Methods <p>This cross-sectional study included 113 patients on predilution online hemodiafiltration (pre-OHDF) as of 1 July 2023. Univariate and multiple regression analyses were performed to investigate factors associated with the RR of α1MG.</p> Results <p>In univariate analysis, the RR of α1MG was significantly correlated with age, normalized protein catabolism rate (nPCR), membrane surface area, blood flow rate, ultrafiltration volume, and albumin leakage, but not with body mass index, albumin, C-reactive protein, substitution volume, transmembrane pressure, or <i>Kt</i>/<i>V</i>.</p> <p>In multiple regression analysis, the RR of α1MG remained significantly correlated with nPCR (<i>P</i> = 0.007) and albumin leakage (<i>P</i> &lt; 0.001).</p> Conclusions <p>These findings suggest that in patients undergoing pre-OHDF with high protein intake, the use of high albumin leakage membranes rather than increasing the dialysis dose can significantly increase the RR of α1MG.</p> <p><i>Trial registration</i> UMIN Clinical Trials Registry, UMIN000055718. Prospectively registered 3 October 2024. <a href="https://center6.umin.ac.jp/cgi-bin/ctr/ctr_view_reg.cgi?recptno=R000063229">https://center6.umin.ac.jp/cgi-bin/ctr/ctr_view_reg.cgi?recptno=R000063229</a></p>

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High albumin leakage rather than increased dialysis dose can increase the α1-microglobulin reduction ratio in patients on predilution online hemodiafiltration

  • 期刊论文

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  • 发表日期：

    2025年2月14日

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  • Kazuyoshi Okada,
  • Manabu Tashiro,
  • Hiroyuki Michiwaki,
  • Sumiyo Yamaguchi,
  • Tomoko Inoue,
  • Jun Minakuchi

摘要

Background

When increasing the reduction ratio (RR) of α1-microglobulin (α1MG) to improve symptoms, the dialysis dose is usually increased. However, no studies on its effectiveness have been reported.

Methods

This cross-sectional study included 113 patients on predilution online hemodiafiltration (pre-OHDF) as of 1 July 2023. Univariate and multiple regression analyses were performed to investigate factors associated with the RR of α1MG.

Results

In univariate analysis, the RR of α1MG was significantly correlated with age, normalized protein catabolism rate (nPCR), membrane surface area, blood flow rate, ultrafiltration volume, and albumin leakage, but not with body mass index, albumin, C-reactive protein, substitution volume, transmembrane pressure, or Kt/V.

In multiple regression analysis, the RR of α1MG remained significantly correlated with nPCR (P = 0.007) and albumin leakage (P < 0.001).

Conclusions

These findings suggest that in patients undergoing pre-OHDF with high protein intake, the use of high albumin leakage membranes rather than increasing the dialysis dose can significantly increase the RR of α1MG.

Trial registration UMIN Clinical Trials Registry, UMIN000055718. Prospectively registered 3 October 2024. https://center6.umin.ac.jp/cgi-bin/ctr/ctr_view_reg.cgi?recptno=R000063229