Impact of Medium Cut-Off Dialyzers on Patient-Reported Outcomes: COREXH Registry.
INTRODUCTION
A new generation of hemodialysis (HD) membranes called medium cut-off (MCO) membranes possesses enhanced capacities for middle molecule clearance, which have been associated with adverse outcomes in this population. These improvements could potentially positively impact patient-reported outcomes (PROs).


OBJECTIVE
The objective of this study was to evaluate the impact of MCO membranes on PROs in a cohort of HD patients in Colombia.


METHODS
This was a prospective, multicenter, observational cohort study of 992 patients from 12 renal clinics in Colombia who were switched from high-flux HD to MCO therapy and observed for 12 months. Changes in Kidney Disease Quality of Life 36-Item Short Form Survey (KDQoL-SF36) domains, Dialysis Symptom Index (DSI), and restless legs syndrome (RLS) 12 months after switching to MCO membranes were compared with time on high-flux membranes. Repeated measures of ANOVA were used to evaluate changes in KDQoL-SF36 scores; severity scoring was used to assess DSI changes over time; Cochran's Q test was used to evaluate changes in frequency of diagnostic criteria of RLS.


RESULTS
During 12 months of follow-up, 3 of 5 KDQoL-SF36 domains improved compared with baseline: symptoms (p < 0.0001), effects of kidney disease (p < 0.0001), and burden of kidney disease (p < 0.001). The proportion of patients diagnosed with RLS significantly decreased from 22.1% at baseline to 10% at 12 months (p < 0.0001). No significant differences in the number of symptoms (DSI, p = 0.1) were observed, although their severity decreased (p = 0.009).


CONCLUSIONS
In conventional HD patients, the expanded clearance of large middle molecules with MCO-HD membranes was associated with higher health-related quality of life scores and a decrease in the prevalence of RLS.
['Alarcon|Juan Carlos|JC|', 'Bunch|Alfonso|A|', 'Ardila|Freddy|F|', 'Zuñiga|Eduardo|E|', 'Vesga|Jasmin I|JI|', 'Rivera|Angela|A|', 'Sánchez|Ricardo|R|', 'Sanabria|Rafael Mauricio|RM|', '|||']
D000368:Aged D003105:Colombia D005260:Female D005500:Follow-Up Studies D006801:Humans D007676:Kidney Failure, Chronic D008297:Male D008567:Membranes, Artificial D008875:Middle Aged D000071066:Patient Reported Outcome Measures D011446:Prospective Studies D011788:Quality of Life D012042:Registries D006435:Renal Dialysis D012148:Restless Legs Syndrome
Hemodialysis Dialysis symptoms Restless legs syndrome Health-related quality of life Medium cut-off membrane