{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T16:49:40Z","timestamp":1782233380779,"version":"3.54.5"},"reference-count":25,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"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"],"abstract":"<jats:p>Introduction: The optimal duration of hemoadsorption durations combined with hemodialysis (HAHD) for maintenance hemodialysis (MHD) patients remains unclear. Methods: In this randomized controlled trial, we randomized 100 MHD patients to receive either 2-h HAHD group (HD + 2-h HP, n = 50) or 4-h HAHD group (HD + 4-h HP, n = 50) to compare treatment safety and efficacy profiles, with an additional 8 patients enrolled for hemoadsorber saturation assessment. This study received ethical approval from the Institutional Review Board (IRB No. [2024] No. 14). Results: Results showed that both treatments significantly reduced serum levels of parathyroid hormone and \u03b22-microglobulin, hippuric acid (HA), indole-3-acetic acid (IAA), p-cresyl sulphate (PCS), and kynurenine (KYN) (p &lt; 0.05), with the 4-h HAHD group demonstrating greater clearance of indoxyl sulphate (IS) (p &lt; 0.05) and significantly higher removal rates for HA, IAA, IS, PCS, and KYN compared to 2-h HAHD (p &lt; 0.05). While protein-bound uremic toxins (PBUTs) clearance was similar at 2 h, the 4-h HAHD group achieved superior HA and IAA clearance by 4 h (p &lt; 0.05). Both treatments were well tolerated, with no hematologic abnormalities and comparable adverse event rates. Conclusion: These findings suggest that 4-h HAHD offers enhanced PBUTs clearance over 2-h HAHD while maintaining a favorable safety profile, supporting its clinical utility in MHD patients.<\/jats:p>","DOI":"10.1159\/000551824","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T16:00:37Z","timestamp":1776355237000},"page":"1-13","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Study on Four- versus Two-Hour Hemoadsorption Combined with Hemodialysis for Enhanced Clearance of Protein-Bound Uremic Toxins in Maintenance Hemodialysis Patients"],"prefix":"10.1159","author":[{"given":"Yang","family":"Lu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-juan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guo-sheng","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun-kai","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin-xin","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi-ying","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gui-zhen","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing-yi","family":"Wan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong-tao","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,4,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kisu.2019.11.001"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l5873"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfy179"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.10110917"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.16338"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-022-04009-w"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1159\/000525225"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1159\/000507912"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1159\/000518857"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1159\/000514187"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.3390\/toxins12030170"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1159\/000545988"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1021\/acsami.5c18435"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.3390\/toxins17080392"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2304820"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2021.686249"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2000.07607.x"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2008080899"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1159\/000502331"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000006160"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.5301\/IJAO.2011.7748"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.impact.2021.100299"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.trsl.2020.09.001"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.03980609"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2013121283"}],"container-title":["Blood Purification"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000551824","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T16:01:01Z","timestamp":1782230461000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000551824"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,16]]},"references-count":25,"URL":"https:\/\/doi.org\/10.1159\/000551824","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.32019861","asserted-by":"subject"}]},"ISSN":["0253-5068","1421-9735"],"issn-type":[{"value":"0253-5068","type":"print"},{"value":"1421-9735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,16]]}}}