Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/26179
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dc.contributor.authorTiong, Mark K-
dc.contributor.authorKrishnasamy, Rathika-
dc.contributor.authorSmith, Edward R-
dc.contributor.authorHutchison, Colin A-
dc.contributor.authorRyan, Elizabeth G-
dc.contributor.authorPascoe, Elaine M-
dc.contributor.authorHawley, Carmel M-
dc.contributor.authorHewitson, Tim D-
dc.contributor.authorJardine, Meg J-
dc.contributor.authorRoberts, Matthew A-
dc.contributor.authorCho, Yeoungjee-
dc.contributor.authorWong, Muh Geot-
dc.contributor.authorHeath, Anne-
dc.contributor.authorNelson, Craig L-
dc.contributor.authorSen, Shaundeep-
dc.contributor.authorMount, Peter F-
dc.contributor.authorVergara, Liza A-
dc.contributor.authorPaul-Brent, Peta-Anne-
dc.contributor.authorJohnson, David W-
dc.contributor.authorToussaint, Nigel D-
dc.date2021-03-28-
dc.date.accessioned2021-04-08T02:43:51Z-
dc.date.available2021-04-08T02:43:51Z-
dc.date.issued2021-03-28-
dc.identifier.citationHemodialysis International 2021; online first: 28 Marchen_US
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/26179-
dc.description.abstractHemodialysis (HD) with medium cut-off (MCO) dialyzers may expand molecular clearance, predominantly larger middle molecules (molecular weight 25-60 kDa). However, the impact of MCO dialyzers on long-term clearance of various other components of the uremic milieu is unknown. The tRial Evaluating Mid cut-Off Value membrane clearance of Albumin and Light chains in HemoDialysis patients (REMOVAL-HD) provided an opportunity to assess the effect of MCO dialyzers on protein-bound uremic toxins and novel markers of mineral metabolism. This exploratory sub-study of REMOVAL-HD evaluated changes in protein-bound solutes (total and free indoxyl sulfate [IS] and p-cresyl sulfate [PCS]) and mineral metabolism markers (intact fibroblast growth factor-23 [iFGF23], fetuin-A and endogenous calciprotein particles [CPP-1 and CPP-2]). Mid-week, pre-HD serum samples were collected at baseline and after 12 and 24 weeks of MCO use in stable adult patients. Change from baseline to Week 12 and 24 was estimated using linear mixed effects models. Eighty-nine participants were studied (mean age 67 ± 15 years, 38% female, 51% diabetic, median urine output 200 ml/24 h). Serum iFGF23 was reduced at Week 12 compared to baseline (-26.8% [95%CI -39.7, -11.1], p = 0.001), which was sustained at Week 24 (-21.7% [95%CI -35.7, -4.5], p = 0.012). There was no significant change in serum IS, PCS, fetuin-A, CPP-1, or CPP-2. The use of a MCO dialyzer over 24 weeks was associated with a sustained reduction in FGF23, while other measured components of the uremic milieu were not significantly altered. Further studies are required to determine whether FGF23 reduction is associated with improved patient outcomes.en_US
dc.language.isoeng
dc.subjectcalciprotein particlesen_US
dc.subjectfetuin-Aen_US
dc.subjectfibroblast growth factor 23en_US
dc.subjectmedium cut-off dialyzeren_US
dc.subjectprotein-bound uremic toxinsen_US
dc.titleEffect of a medium cut-off dialyzer on protein-bound uremic toxins and mineral metabolism markers in patients on hemodialysis.en_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleHemodialysis Internationalen_US
dc.identifier.affiliationWestern Health Chronic Disease Alliance, Western Centre for Health Research and Education, Western Health, St Albans, Australiaen_US
dc.identifier.affiliationEastern Health Clinical School, Monash University, Melbourne, Australiaen_US
dc.identifier.affiliationNephrologyen_US
dc.identifier.affiliationDepartment of Nephrology, Western Health, Melbourne, Australiaen_US
dc.identifier.affiliationDepartment of Medicine, Western Health, University of Melbourne, Melbourne, Australiaen_US
dc.identifier.affiliationAustralasian Kidney Trials Network, The University of Queensland, Brisbane, Australiaen_US
dc.identifier.affiliationDepartment of Nephrology, Princess Alexandra Hospital, Brisbane, Australiaen_US
dc.identifier.affiliationTranslational Research Institute, Brisbane, Queensland, Australiaen_US
dc.identifier.affiliationQCIF Facility for Advanced Bioinformatics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australiaen_US
dc.identifier.affiliationNHMRC Clinical Trials Centre, University of Sydney, Sydney, Australiaen_US
dc.identifier.affiliationThe George Institute for Global Health, UNSW, Sydney, Australiaen_US
dc.identifier.affiliationSAN Renal Dialysis Unit, Sydney Adventist Hospital, Sydney, Australiaen_US
dc.identifier.affiliationDepartment of Nephrology, Concord Repatriation and General Hospital, Sydney, Australiaen_US
dc.identifier.affiliationDepartment of Nephrology, The Royal Melbourne Hospital, Parkville, Australiaen_US
dc.identifier.affiliationDepartment of Medicine (RMH), University of Melbourne, Parkville, Australiaen_US
dc.identifier.affiliationDepartment of Nephrology, Sunshine Coast University Hospital, Birtinya, Australiaen_US
dc.identifier.affiliationDepartment of Medicine, Hawke's Bay Hospital, Hawkes Bay, New Zealanden_US
dc.identifier.doi10.1111/hdi.12924en_US
dc.type.contentTexten_US
dc.identifier.orcid0000-0001-9348-4638en_US
dc.identifier.pubmedid33779046
local.name.researcherMount, Peter F
item.languageiso639-1en-
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.cerifentitytypePublications-
item.openairetypeJournal Article-
crisitem.author.deptNephrology-
crisitem.author.deptInstitute for Breathing and Sleep-
crisitem.author.deptMedicine (University of Melbourne)-
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