{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T20:43:09Z","timestamp":1793652189349,"version":"4.5.1"},"reference-count":19,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Seminars in Dialysis"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Microinflammation and functional iron deficiency are major contributors to anemia and treatment burden in maintenance hemodialysis (HD). Medium cutoff (MCO) membranes enhance the removal of middle\u2010 and large\u2010sized solutes implicated in these pathways, yet real\u2010world data using routinely measured inflammatory and iron\u2010related markers are scarce. This study examined the effects of MCO\u2010based expanded HD on inflammatory indices, iron metabolism, and anemia\u2010related treatment requirements. In this single\u2010center retrospective study, 22 maintenance HD patients (11 who continued on high\u2010flux dialyzers and 11 who were switched to MCO dialyzers) were followed for 24\u2009weeks. Baseline and 24\u2010week assessments included C\u2010reactive protein (CRP), the CRP\/albumin ratio, neutrophil count, and composite inflammatory indices, as well as serum iron, transferrin saturation (TSAT), total iron\u2010binding capacity (TIBC), and ferritin. Monthly intravenous iron supplementation and weekly erythropoiesis\u2010stimulating agent (ESA) doses were also documented. Baseline characteristics were comparable between groups. Over the 24\u2010week period, the MCO group showed a significant decline in neutrophil count (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.042) and downward trends in CRP and the CRP\/albumin ratio, while both markers increased significantly in patients maintained on high\u2010flux dialyzers. Serum albumin remained stable in all participants. Parallel to the improvement in inflammation, the MCO group demonstrated significant enhancements in iron\u2010handling parameters, with higher serum iron (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.008) and TSAT (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.005), and lower TIBC (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.007), none of which were observed in the high\u2010flux group. Between\u2010group \u0394\u2010differences were significant for CRP (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.010), CRP\/albumin ratio (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.013), serum iron (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.040), TIBC (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.005), and TSAT (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.005). Hemoglobin levels remained stable in both groups, while intravenous iron and ESA requirements showed modest within\u2010group reductions in the MCO cohort. In this exploratory retrospective analysis, MCO membrane use was associated with favorable trends in inflammatory markers and iron\u2010handling parameters, alongside modest within\u2010group reductions in intravenous iron and ESA requirements, without compromising serum albumin. These findings suggest that MCO therapy may help mitigate microinflammation and support more efficient anemia management in real\u2010world HD practice.\n                  <\/jats:p>","DOI":"10.1111\/sdi.70033","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T13:59:52Z","timestamp":1777557592000},"page":"105-115","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Expanded Hemodialysis on Inflammation and Iron Metabolism in Chronic Hemodialysis Patients"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0834-900X","authenticated-orcid":false,"given":"Berrak\u00a0It\u0131r","family":"Ayl\u0131","sequence":"first","affiliation":[{"name":"University of Westminster  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0770-1283","authenticated-orcid":false,"given":"G\u00fclay\u00a0Ulusal","family":"Okyay","sequence":"additional","affiliation":[{"name":"Department of Nephrology University of Health Sciences, Etlik City Hospital  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3145-1595","authenticated-orcid":false,"given":"Mehmet\u00a0Deniz","family":"Ayl\u0131","sequence":"additional","affiliation":[{"name":"Department of Nephrology University of Health Sciences, Etlik City Hospital  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523\u20101755.63.s84.43.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.02660221"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.24875\/RIC.23000223"},{"key":"e_1_2_8_5_1","volume-title":"T\u00fcrkiye'de Nefroloji, Diyaliz ve Transplantasyon: Registry of the Nephrology, Dialysis and Transplantation in Turkey 2023","author":"Turkish Society of Nephrology & Ministry of Health of T\u00fcrkiye","year":"2024"},{"key":"e_1_2_8_6_1","volume-title":"T\u00fcrkiye'de Nefroloji, Diyaliz ve Transplantasyon: Registry of the Nephrology, Dialysis and Transplantation in Turkey 2024","author":"Turkish Society of Nephrology & Ministry of Health of T\u00fcrkiye","year":"2025"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfy202"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfad033"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.5301\/ijao.5000603"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/cells9092039"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010020\u201073124\u2010x"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0220448"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/03913988241236736"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1159\/000513328"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/1744\u20109987.13620"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2025.06.005"},{"key":"e_1_2_8_17_1","unstructured":"Republic of T\u00fcrkiye Social Security Institution \u201cSa\u011fl\u0131k Uygulama Tebli\u011fi (SUT). Official Gazette \u201d (2023)."},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11255\u2010020\u201002562\u20103"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/hdi.13166"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/hdi.13232"}],"container-title":["Seminars in Dialysis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/sdi.70033","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/sdi.70033","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/sdi.70033","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T14:51:32Z","timestamp":1779461492000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/sdi.70033"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,30]]},"references-count":19,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1111\/sdi.70033"],"URL":"https:\/\/doi.org\/10.1111\/sdi.70033","archive":["Portico"],"relation":{},"ISSN":["0894-0959","1525-139X"],"issn-type":[{"value":"0894-0959","type":"print"},{"value":"1525-139X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,30]]},"assertion":[{"value":"2025-12-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}