{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:20:18Z","timestamp":1790612418391,"version":"4.1.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2020,11,30]],"date-time":"2020-11-30T00:00:00Z","timestamp":1606694400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Baxter Healthcare"},{"DOI":"10.13039\/100012352","name":"University of Milan","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012352","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The retention of a large number of solutes that are normally excreted or metabolized by the kidney is responsible for the symptoms typical in uraemic patients. These molecules are defined as uraemic toxins and can be classified into three groups: small water-soluble molecules, middle molecules and protein-bound toxins. Recently, efforts were put towards developing dialysis membranes that allow the removal of large middle molecules without clinically relevant albumin loss. These membranes are the medium cut-off (MCO) membranes that allow the removal of middle molecules up to \u223c50\u2009000\u2009Da.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We performed a prospective, open-label, controlled, cross-over pilot study comparing expanded haemodialysis (HDx) (novel MCO membrane Theranova 400) and conventional haemodialysis (HD) in 20 prevalent HD patients. Ten patients used conventional HD high-flux dialyser and 10 patients used HDx for 3\u2009months; later the patients switched and received the other treatment for a further 3\u2009months. We then analysed the pro-calcifying effect of uraemic serum in a model of high phosphate(Pi)\u2013induced calcification in vascular smooth muscle cells (VSMCs).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In this study, every patient was the control of himself and, interestingly, we found a tendency of less pro-calcifying potential from HDx-treated patients\u2019 serum compared with HD. Studying pathogenetic processes involved in high Pi\u2013induced calcium deposition, we found that uraemic serum of HDx-treated patients induced less VSMC necrosis compared with uraemic serum of HD patients. Nevertheless, no differences were found between the different dialytic treatments in the serum potential to induce apoptosis and to modulate the expression of a panel of genes involved in VSMC simil-osteoblastic differentiation such as bone morphogenetic protein 2, runt-related transcription factor 2, osteocalcin, matrix Gla protein, osteopontin, elastin and collagen I \u03b11. In an effort to characterize the difference in uraemic toxin profile during the two different dialytic treatments, we measured a panel of 10 uraemic toxins and 3 precursors, finding a significant increased removal during HDx of 3-carboxy-4-methyl-5-propyl-2-furanpropanoic acid, tryptophane and some of its metabolites, such as 3-indoxyl sulphate, indole 3-acetic acid and kynurenine.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>These preliminary data are promising, although larger patients\u2019 groups are needed to better understand the effects of HDx on vascular calcification.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ckj\/sfaa216","type":"journal-article","created":{"date-parts":[[2020,10,16]],"date-time":"2020-10-16T11:11:17Z","timestamp":1602846677000},"page":"1798-1807","source":"Crossref","is-referenced-by-count":9,"title":["Pro-calcifying analysis of uraemic serum from patients treated with medium cut-off membrane in a prospective, cross-over study"],"prefix":"10.1093","volume":"14","author":[{"given":"Paola","family":"Ciceri","sequence":"first","affiliation":[{"name":"Department of Nephrology, Dialysis and Renal Transplant, Renal Research Laboratory, Fondazione Ca\u2019 Granda IRCCS, Ospedale Maggiore Policlinico, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia","family":"Tettamanti","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Renal Division, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Galassi","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Renal Division, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenza","family":"Magagnoli","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Renal Division, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Fabresse","sequence":"additional","affiliation":[{"name":"Laboratory of Pharmacology and Toxicology, CHU Raymond Poincare, Garches, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Claude","family":"Alvarez","sequence":"additional","affiliation":[{"name":"Laboratory of Pharmacology and Toxicology, CHU Raymond Poincare, Garches, France"},{"name":"INSERM U-1173, UFR des Sciences de la Sant\u00e9 Simone Veil, Universit\u00e9 Paris-Saclay (Versailles-Saint-Quentin-en-Yvelines), Montigny le Bretonneux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziad A","family":"Massy","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Ambroise Par\u00e9 University Hospital, APHP, Boulogne-Billancourt\/Paris, Paris, France"},{"name":"Centre for Research in Epidemiology and Population Health (CESP), INSERM UMRS 1018, Universit\u00e9 Paris-Saclay, Universit\u00e9 Versailles Saint Quentin (UVSQ), Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piergiorgio","family":"Messa","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Dialysis and Renal Transplant, Renal Research Laboratory, Fondazione Ca\u2019 Granda IRCCS, Ospedale Maggiore Policlinico, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8494-6252","authenticated-orcid":false,"given":"Mario","family":"Cozzolino","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Renal Division, ASST Santi Paolo e Carlo, University of Milan, Milan, 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