Efficacy of medium cut off dialyzers and Comparision with High-Flux dialyzers in patients on maintenance hemodialysis: a Systematic Review and Meta-Analysis.

INTRODUCTION Medium cut-off (MCO) dialyzers were designed to provide better clearance of uremic toxins. METHODS We conducted a meta-analysis comparing MCO with high-flux (HF) dialyzers for the effect on uremic toxins in maintenance hemodialysis(HD) patients. Five databases were systematically searched for relevant studies and 9 studies were identified finally. RESULTS Reduction ratio (RR) of urea, urea, creatinine, β2-macroglobulin(β2-MG), kappa free light chain(κFLC) and lambda FLC(λFLC) levels were not significantly different between MCO and HF dialyzers. But RR of β2-MG, κFLC and λFLC were greater for MCO than HF dialyzers. MCO dialyzers could better reduce tumor necrosis factor-α(TNF-α) levels. Subgroup analysis stratified by study design indicated that in randomized controlled trial(RCT) studies, albumin levels was lower in MCO than HF dialyzers group, but the two dialyzers treatments were equivalent in non-RCT subgroup. CONCLUSIONS Compared with HF dialyzers, MCO dialyzers provided higher middle-molecules uremic toxins clearance and obviously reduced TNF-α levels. This article is protected by copyright. All rights reserved.