{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T01:38:51Z","timestamp":1789004331762,"version":"build-2803163510"},"reference-count":0,"publisher":"S. Karger AG","issue":"2","license":[{"start":{"date-parts":[[2023,11,8]],"date-time":"2023-11-08T00:00:00Z","timestamp":1699401600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2023,11,8]],"date-time":"2023-11-08T00:00:00Z","timestamp":1699401600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Blood Purif"],"published-print":{"date-parts":[[2024]]},"abstract":"<b><i>Introduction:<\/i><\/b> The removal of low- and medium-molecular-weight proteins has been improved with online hemodiafiltration (OL-HDF) and hemodialysis using high-flux membranes; however, the outcomes of patients with end-stage kidney disease (ESKD) undergoing dialysis treatment are still worse than in the general population. \u03b1<sub>1<\/sub>-Microglobulin (\u03b1<sub>1<\/sub>-m), with a molecular weight of 33,000 Da, may contribute to dialysis-related disorders and mortality. However, the removal is insufficient even with current OL-HDF using the polysulfone (PS) membrane, which is common in Japan. Polymethylmethacrylate (PMMA) membranes can remove medium- to high-molecular-weight proteins by adsorption. This study aimed to assess the efficacy of removing medium- to high-molecular-weight proteins, such as \u03b1<sub>1<\/sub>-m and \u03b2<sub>2<\/sub>-microglobulin (\u03b2<sub>2<\/sub>-m), through post-dilution OL-HDF with PMMA (Post-PMMA). The assessment was conducted in comparison to pre-dilution OL-HDF with PS (Pre-PS), using an open-label, single-arm study. <b><i>Methods:<\/i><\/b> Seven patients with ESKD on Pre-PS underwent Post-PMMA with replacement volume of 30 mL\/min (low flow) and 50 mL\/min (high flow). Clearance and removal rates of \u03b1<sub>1<\/sub>-m, \u03b2<sub>2<\/sub>-m, small molecules, inflammatory cytokines, and albumin were measured at 60 and 240 min of treatment. <b><i>Results:<\/i><\/b> Clearance rates of \u03b1<sub>1<\/sub>-m at 60 min were \u22122.8 \u00b1 5.2 mL\/min with Pre-PS, \u22120.4 \u00b1 2.6 mL\/min with Post-PMMA (low), and 0.6 \u00b1 3.4 mL\/min with Post-PMMA (high). The removal rate of \u03b1<sub>1<\/sub>-m was higher in Post-PMMA than that in Pre-HDF-PS (Post-PMMA [high] 17.7 \u00b1 5.9%, Post-PMMA [low] 15.0 \u00b1 5.6%, and Pre-PS 4.1 \u00b1 5.5%). Adsorption clearance of \u03b2<sub>2<\/sub>-m was increased with Post-PMMA. Albumin leakage in Post-PMMA was not higher than that in Pre-PS. <b><i>Conclusion:<\/i><\/b> The removal rate of \u03b1<sub>1<\/sub>-m with Post-PMMA was higher than that with Pre-PS. The PMMA membrane adsorbed \u03b2<sub>2<\/sub>-m, suggesting the removal effect of medium- to high-molecular-weight proteins by the adsorption method. Since Post-PMMA effectively removes \u03b1<sub>1<\/sub>-m without excessive albumin leakage, it will be useful for patients with ESKD, especially those with a poor nutritional status. <\/jats:p>","DOI":"10.1159\/000534459","type":"journal-article","created":{"date-parts":[[2023,11,8]],"date-time":"2023-11-08T22:00:35Z","timestamp":1699480835000},"page":"123-129","source":"Crossref","is-referenced-by-count":4,"title":["Removal of \u03b1<sub>1<\/sub>-Microglobulin Using Post-Dilution Online Hemodiafiltration with Polymethylmethacrylate Membrane: An Open-Label, Single-Arm Study"],"prefix":"10.1159","volume":"53","author":[{"given":"Shiori","family":"Yoshida","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suguru","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Miyauchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryohei","family":"Terashima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Hashimoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruna","family":"Miyazawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Ishizawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mototsugu","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiko","family":"Tomita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ikuo","family":"Aoike","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin","family":"Goto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ichiei","family":"Narita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2023,11,8]]},"container-title":["Blood Purification"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/bpu\/article-pdf\/53\/2\/123\/4163975\/000534459.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/bpu\/article-pdf\/53\/2\/123\/4163975\/000534459.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T15:47:11Z","timestamp":1745423231000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000534459"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,8]]},"references-count":0,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,2,1]]},"published-print":{"date-parts":[[2024,1,31]]}},"URL":"https:\/\/doi.org\/10.1159\/000534459","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.24487111","asserted-by":"subject"}]},"ISSN":["0253-5068","1421-9735"],"issn-type":[{"value":"0253-5068","type":"print"},{"value":"1421-9735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,8]]}}}