{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T10:22:48Z","timestamp":1760523768530},"reference-count":34,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,3,12]],"date-time":"2019-03-12T00:00:00Z","timestamp":1552348800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hemodialysis International"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p><jats:bold>Introduction<\/jats:bold>:  Small molecular weight toxin clearance is the main method of assessment of hemodialysis efficiency. Middle molecules including cystatin C (CysC) and Beta\u20102 microglobulin (\u03b22\u2010M) are understudied. We hypothesized that lowering of predialysis CysC and \u03b22\u2010M serum concentrations would be affected by switching to more frequent hemodialysis.<\/jats:p><jats:p><jats:bold>Methods<\/jats:bold>:  Predialysis CysC and \u03b22\u2010M serum concentrations were measured from serum samples of the Frequent Hemodialysis Network (FHN) Daily and Nocturnal Trials. The differences between predialysis concentrations at baseline (while on conventional thrice weekly dialysis) and those after 12\u2010months of study (on more frequent dialysis) were compared separately by trial (Nocturnal, Daily). We tested the associations between predialysis serum CysC and \u03b22\u2010M concentrations and outcomes.<\/jats:p><jats:p><jats:bold>Findings<\/jats:bold>:  Forty\u2010nine percent and 52% of the patients from the FHN Daily and Nocturnal Trials respectively were included in this ancillary study. Predialysis serum CysC concentrations remained unchanged after intensifying hemodialysis dose by either modality. There was significant lowering of the serum \u03b22\u2010M concentrations in the frequent Daily Trial hemodialysis group at 12\u2009months in all patients and in patients without residual renal function at baseline (\u22123.8\u2009\u00b1\u200912.62\u2009\u03bcg\/mL, P\u2009=\u20090.004; \u22125.9\u2009\u00b1\u200912.99\u2009\u03bcg\/mL, P\u2009=\u20090.02, respectively). There were no significant differences between the baseline and the 12\u2010months predialysis \u03b22\u2010M serum concentrations in the two control groups (Daily 3\u00d7 and Nocturnal 3\u00d7 groups). No association between the changes in the two biomarkers between baseline and 12\u2010months and in changes in left ventricular mass, physical\u2010health composite scores, hospitalization rate, and death were found. The numbers of hospitalizations and deaths were small.<\/jats:p><jats:p><jats:bold>Discussion<\/jats:bold>: \u03b22\u2010M may be a better biomarker of dialysis dose than CysC. Reduction in the concentration of potentially toxic long\u2010lived proteins of the size of \u03b2\u20102M is one potential long\u2010term benefit of more intensive dialysis that may be explored.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hdi.12749","type":"journal-article","created":{"date-parts":[[2019,3,12]],"date-time":"2019-03-12T15:47:57Z","timestamp":1552405677000},"page":"297-305","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The effect of increased frequency of hemodialysis on serum cystatin C and \u03b22\u2010microglobulin concentrations: A secondary analysis of the frequent hemodialysis network (FHN) trial"],"prefix":"10.1111","volume":"23","author":[{"given":"Shih\u2010Han S.","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Nephrology Western University  London Canada"},{"name":"Department of Medical Biophysics Western University  London 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