{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:28:18Z","timestamp":1790310498932,"version":"4.1.0"},"reference-count":35,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Studies on Adsorption International Learning Initiative Global (SAILING) program","award":["SAILING-2024016"],"award-info":[{"award-number":["SAILING-2024016"]}]},{"name":"Studies on Adsorption International Learning Initiative Global (SAILING) program","award":["ZYGD23015"],"award-info":[{"award-number":["ZYGD23015"]}]},{"name":"Studies on Adsorption International Learning Initiative Global (SAILING) program","award":["2025JDKP0138"],"award-info":[{"award-number":["2025JDKP0138"]}]},{"name":"1.3.5 project for disciplines of excellence from West China Hospital of Sichuan University","award":["SAILING-2024016"],"award-info":[{"award-number":["SAILING-2024016"]}]},{"name":"1.3.5 project for disciplines of excellence from West China Hospital of Sichuan University","award":["ZYGD23015"],"award-info":[{"award-number":["ZYGD23015"]}]},{"name":"1.3.5 project for disciplines of excellence from West China Hospital of Sichuan University","award":["2025JDKP0138"],"award-info":[{"award-number":["2025JDKP0138"]}]},{"name":"Sichuan Province Science Popularization Training Program","award":["SAILING-2024016"],"award-info":[{"award-number":["SAILING-2024016"]}]},{"name":"Sichuan Province Science Popularization Training Program","award":["ZYGD23015"],"award-info":[{"award-number":["ZYGD23015"]}]},{"name":"Sichuan Province Science Popularization Training Program","award":["2025JDKP0138"],"award-info":[{"award-number":["2025JDKP0138"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>Protein-bound uraemic toxins (PBUTs), such as indoxyl sulphate (IS) and p-cresyl sulphate (PCS), are poorly cleared by conventional haemodialysis (HD) or haemodiafiltration (HDF). Haemoadsorption combined with HD (HAHD) using the novel pHA130 cartridge may increase PBUT removal, and this trial aimed to compare its efficacy and safety with HDF in patients with end-stage renal disease (ESRD). In this single-centre, open-label trial, 30 maintenance HD patients were randomized (1:1:1) to HDF once every two weeks (HDF-q2w), HAHD once every two weeks (HAHD-q2w), or HAHD once weekly (HAHD-q1w) for 8 weeks, with the primary endpoint being the single-session reduction ratio (RR) of IS. The combined HAHD group (n = 20) demonstrated a significantly greater IS reduction than the HDF-q2w group (n = 10) (46.9% vs. 31.8%; p = 0.044) and superior PCS clearance (44.6% vs. 31.4%; p = 0.003). Both HAHD regimens significantly reduced predialysis IS levels at Week 8. Compared with HDF, weekly HAHD provided greater relief from pruritus and improved sleep quality, with comparable adverse events among groups. In conclusion, HAHD with the pHA130 cartridge is more effective than HDF for enhancing single-session PBUT removal and alleviating uraemic symptoms in patients with ESRD, with weekly application showing optimal symptomatic benefits.<\/jats:p>","DOI":"10.3390\/toxins17080392","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T13:44:32Z","timestamp":1754401472000},"page":"392","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Comparative Efficacy of pHA130 Haemoadsorption Combined with Haemodialysis Versus Online Haemodiafiltration in Removing Protein-Bound and Middle-Molecular-Weight Uraemic Toxins: A Randomized Controlled Trial"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2817-3619","authenticated-orcid":false,"given":"Shaobin","family":"Yu","sequence":"first","affiliation":[{"name":"Department of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University, Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huaihong","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University, Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohong","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University, Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yalin","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University, Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University, Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1918","DOI":"10.2215\/CJN.02660221","article-title":"Classification of Uremic Toxins and Their Role in Kidney Failure","volume":"16","author":"Rosner","year":"2021","journal-title":"Clin. J. Am. Soc. Nephrol. CJASN"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1053\/j.jrn.2016.07.005","article-title":"Protein-Bound Uremic Toxins from Gut Microbiota and Inflammatory Markers in Chronic Kidney Disease","volume":"26","author":"Borges","year":"2016","journal-title":"J. Ren. Nutr."},{"key":"ref_3","first-page":"iii6","article-title":"Large uremic toxins: An unsolved problem in end-stage kidney disease","volume":"33","author":"Wolley","year":"2018","journal-title":"Nephrol. Dial. Transpl. Off. Publ. Eur. Dial. Transpl. Assoc.-Eur. Ren. Assoc."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Graboski, A.L., and Redinbo, M.R. (2020). Gut-Derived Protein-Bound Uremic Toxins. Toxins, 12.","DOI":"10.3390\/toxins12090590"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.1093\/ckj\/sfaa121","article-title":"Serum total indoxyl sulfate and clinical outcomes in hemodialysis patients: Results from the Japan Dialysis Outcomes and Practice Patterns Study","volume":"14","author":"Yamamoto","year":"2021","journal-title":"Clin. Kidney J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"662","DOI":"10.5114\/aoms.2013.36901","article-title":"Serum p-cresyl sulfate predicts cardiovascular disease and mortality in elderly hemodialysis patients","volume":"9","author":"Lin","year":"2013","journal-title":"Arch. Med. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"6651367","DOI":"10.1155\/2021\/6651367","article-title":"Uremic Toxins, Oxidative Stress, Atherosclerosis in Chronic Kidney Disease, and Kidney Transplantation","volume":"2021","author":"Wojtaszek","year":"2021","journal-title":"Oxidative Med. Cell. Longev."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Cozzolino, M., Magagnoli, L., and Ciceri, P. (2025). From Physicochemical Classification to Multidimensional Insights: A Comprehensive Review of Uremic Toxin Research. Toxins, 17.","DOI":"10.3390\/toxins17060295"},{"key":"ref_9","first-page":"357","article-title":"YKL-40 in patients with end-stage renal disease receiving haemodialysis","volume":"23","author":"Nielsen","year":"2018","journal-title":"Biomark. Biochem. Indic. Expo. Response Susceptibility Chem."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.kint.2017.07.010","article-title":"Mortality prediction in stable hemodialysis patients is refined by YKL-40, a 40-kDa glycoprotein associated with inflammation","volume":"93","author":"Lorenz","year":"2018","journal-title":"Kidney Int."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Krieter, D.H., Kerwagen, S., R\u00fcth, M., Lemke, H.D., and Wanner, C. (2019). Differences in Dialysis Efficacy Have Limited Effects on Protein-Bound Uremic Toxins Plasma Levels over Time. Toxins, 11.","DOI":"10.3390\/toxins11010047"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1038\/s41581-018-0002-x","article-title":"Haemodialysis membranes","volume":"14","author":"Ronco","year":"2018","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1038\/s41581-020-0315-4","article-title":"The current and future landscape of dialysis","volume":"16","author":"Himmelfarb","year":"2020","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"149","DOI":"10.4103\/jesnt.jesnt_4_23","article-title":"Is online hemodiafiltration superior to hemodialysis in removal of indoxyl sulfate in chronic hemodialysis patients? A comparative study","volume":"23","author":"Sarhaan","year":"2023","journal-title":"J. Egypt. Soc. Nephrol. Transpl."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1159\/000350843","article-title":"Removal of protein-bound uraemic toxins by haemodialysis","volume":"35","author":"Niwa","year":"2013","journal-title":"Blood Purif."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Yamamoto, S., Kazama, J.J., Omori, K., Matsuo, K., Takahashi, Y., Kawamura, K., Matsuto, T., Watanabe, H., Maruyama, T., and Narita, I. (2015). Continuous Reduction of Protein-Bound Uraemic Toxins with Improved Oxidative Stress by Using the Oral Charcoal Adsorbent AST-120 in Haemodialysis Patients. Sci. Rep., 5.","DOI":"10.1038\/srep14381"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Sternkopf, M., Thor\u00f6e-Boveleth, S., Beck, T., Oleschko, K., Erlenk\u00f6tter, A., Tschulena, U., Steppan, S., Speer, T., Goettsch, C., and Jankowski, V. (2019). A Bifunctional Adsorber Particle for the Removal of Hydrophobic Uremic Toxins from Whole Blood of Renal Failure Patients. Toxins, 11.","DOI":"10.3390\/toxins11070389"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1945","DOI":"10.1093\/ndt\/gfae089","article-title":"Hemoadsorption: Consensus report of the 30th Acute Disease Quality Initiative workgroup","volume":"39","author":"Bellomo","year":"2024","journal-title":"Nephrol. Dial. Transpl."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1159\/000533258","article-title":"Extracorporeal Techniques in Kidney Failure","volume":"53","author":"Meijers","year":"2024","journal-title":"Blood Purif."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1159\/000525225","article-title":"Randomized Control Study on Hemoperfusion Combined with Hemodialysis versus Standard Hemodialysis: Effects on Middle-Molecular-Weight Toxins and Uremic Pruritus","volume":"51","author":"Zhao","year":"2022","journal-title":"Blood Purif."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1159\/000518857","article-title":"The Effect of Combination Use of Hemodialysis and Hemoperfusion on Microinflammation in Elderly Patients with Maintenance Hemodialysis","volume":"51","author":"Li","year":"2022","journal-title":"Blood Purif."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1111\/sdi.13110","article-title":"Effect of different hemodialysis modalities on hepcidin clearance in patients undergoing maintenance hemodialysis","volume":"36","author":"Sun","year":"2023","journal-title":"Semin. Dial."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1159\/000514187","article-title":"Survival Outcomes of Hemoperfusion and Hemodialysis versus Hemodialysis in Patients with End-Stage Renal Disease: A Systematic Review and Meta-Analysis","volume":"51","author":"Cheng","year":"2022","journal-title":"Blood Purif."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"298","DOI":"10.23876\/j.krcp.22.223","article-title":"Expanding the potential therapeutic options of hemoperfusion in the era of improved sorbent biocompatibility","volume":"42","author":"Damianaki","year":"2023","journal-title":"Kidney Res. Clin. Pract."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1159\/000527953","article-title":"Combined Hemoperfusion-Hemodialysis in End-Stage Renal Disease Patients","volume":"200","author":"Ronco","year":"2023","journal-title":"Contrib. Nephrol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Liu, Y., Peng, X., Hu, Z., Yu, M., Fu, J., and Huang, Y. (2021). Fabrication of a novel nitrogen-containing porous carbon adsorbent for protein-bound uremic toxins removal. Mater. Sci. Eng. C Mater. Biol. Appl., 121.","DOI":"10.1016\/j.msec.2021.111879"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"106265","DOI":"10.1016\/j.reactfunctpolym.2025.106265","article-title":"Simultaneous hypercrosslinking and functionalization of porous polystyrene adsorbent for protein-bound uraemic toxins removal","volume":"214","author":"Chen","year":"2025","journal-title":"React. Funct. Polym."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1111\/aor.14954","article-title":"Efficacy of HA130 Hemoadsorption in Removing Advanced Glycation End Products in Maintenance Hemodialysis Patients","volume":"49","author":"Reis","year":"2025","journal-title":"Artif. Organs"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Marcello, M., Ram\u00edrez-Guerrero, G., Reis, T., and Ronco, C. (2024). Blood purification for the treatment of chronic kidney disease-associated pruritus. Integr. Med. Nephrol. Androl., 11.","DOI":"10.1097\/IMNA-D-24-00005"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e00006","DOI":"10.1097\/IMNA-D-24-00006","article-title":"Hemoadsorption Combined with Hemodialysis and the \u201cInflammation Mitigation Hypothesis\u201d","volume":"11","author":"Brendolan","year":"2024","journal-title":"Integr. Med. Nephrol. Androl."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1508","DOI":"10.2215\/CJN.00300113","article-title":"Renal clearance and intestinal generation of p-cresyl sulfate and indoxyl sulfate in CKD","volume":"8","author":"Poesen","year":"2013","journal-title":"Clin. J. Am. Soc. Nephrol. CJASN"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1932","DOI":"10.2215\/CJN.02940509","article-title":"p-Cresyl sulfate and indoxyl sulfate in hemodialysis patients","volume":"4","author":"Meijers","year":"2009","journal-title":"Clin. J. Am. Soc. Nephrol. CJASN"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"i45","DOI":"10.1093\/ckj\/sfab198","article-title":"Choices in hemodialysis therapies: Variants, personalized therapy and application of evidence-based medicine","volume":"14","author":"Canaud","year":"2021","journal-title":"Clin. Kidney J."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Zhang, D., Liu, C., Yang, T., Zhao, J., Wang, X., Zhang, L., Li, Y., Shen, Y., Gao, Y., and Zhang, H. (2025). Long-Term Safety of \u201c4-Hour\u201d Hemoadsorption Combined with Hemodialysis in Maintenance Hemodialysis Patients: A Multicenter Prospective Cohort Study. Blood Purif., 413\u2013423.","DOI":"10.1159\/000545988"},{"key":"ref_35","first-page":"628","article-title":"No change in corrected beta 2-microglobulin concentration after cuprophane haemodialysis","volume":"1","author":"Wehle","year":"1987","journal-title":"Lancet"}],"container-title":["Toxins"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6651\/17\/8\/392\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:23:49Z","timestamp":1760034229000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6651\/17\/8\/392"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,5]]},"references-count":35,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["toxins17080392"],"URL":"https:\/\/doi.org\/10.3390\/toxins17080392","relation":{},"ISSN":["2072-6651"],"issn-type":[{"value":"2072-6651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,5]]}}}