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Medium Cut-Off Dialysis Membrane and Dietary Fiber Effects on Inflammation and Protein-Bound Uremic Toxins: A Systematic Review and Protocol for an Interventional Study.
Toxins (Basel). 2021 03 29; 13(4)T

Abstract

The aim of this systematic review is to investigate the effects of the use of a medium cut-off membrane (MCO) and dietary fiber on the concentration of protein-bound uremic toxins (PBUTs) and inflammatory markers in hemodialysis (HD) patients. Of 11,397 papers originally found, eight met the criteria of randomized controlled trial design. No study examined the effects of MCO membranes on PBUTs. Three studies examined the reduction in inflammatory markers with MCO membranes compared to high-flux HD membranes and showed no significant differences. Five studies of dietary fiber supplementation showed an inconclusive positive effect on PBUT levels and a significant positive effect on the reduction in inflammatory markers (interleukin-6 reduction: standardized difference in means -1.18; 95% confidence interval -1.45 to -0.9 for dietary fiber supplementation vs. control; p < 0.001). To date, no study has combined the use of an MCO membrane and fiber supplementation to reduce PBUT levels and inflammation with online hemodiafiltration as a comparator. A rationale and protocol for an interventional trial using a combination of MCO membrane dialysis and fiber supplementation to lower inflammatory markers and PBUT concentrations are presented.

Authors+Show Affiliations

Department of Nephrology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia.Department of Nephrology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia.Department of Nephrology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia.Department of Nephrology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia. Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia.

Pub Type(s)

Clinical Trial Protocol
Journal Article
Research Support, Non-U.S. Gov't
Systematic Review

Language

eng

PubMed ID

33805509

Citation

Herič, Tjaša, et al. "Medium Cut-Off Dialysis Membrane and Dietary Fiber Effects On Inflammation and Protein-Bound Uremic Toxins: a Systematic Review and Protocol for an Interventional Study." Toxins, vol. 13, no. 4, 2021.
Herič T, Vivoda T, Bogataj Š, et al. Medium Cut-Off Dialysis Membrane and Dietary Fiber Effects on Inflammation and Protein-Bound Uremic Toxins: A Systematic Review and Protocol for an Interventional Study. Toxins (Basel). 2021;13(4).
Herič, T., Vivoda, T., Bogataj, Š., & Pajek, J. (2021). Medium Cut-Off Dialysis Membrane and Dietary Fiber Effects on Inflammation and Protein-Bound Uremic Toxins: A Systematic Review and Protocol for an Interventional Study. Toxins, 13(4). https://doi.org/10.3390/toxins13040244
Herič T, et al. Medium Cut-Off Dialysis Membrane and Dietary Fiber Effects On Inflammation and Protein-Bound Uremic Toxins: a Systematic Review and Protocol for an Interventional Study. Toxins (Basel). 2021 03 29;13(4) PubMed PMID: 33805509.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Medium Cut-Off Dialysis Membrane and Dietary Fiber Effects on Inflammation and Protein-Bound Uremic Toxins: A Systematic Review and Protocol for an Interventional Study. AU - Herič,Tjaša, AU - Vivoda,Tjaša, AU - Bogataj,Špela, AU - Pajek,Jernej, Y1 - 2021/03/29/ PY - 2020/11/30/received PY - 2021/03/22/revised PY - 2021/03/25/accepted PY - 2021/4/3/entrez PY - 2021/4/4/pubmed PY - 2021/6/30/medline KW - IL-6 KW - dietary fiber supplementation KW - indoxyl sulfate KW - inflammation KW - medium cut-off membrane KW - p-cresyl sulfate KW - protein-bound uremic toxins JF - Toxins JO - Toxins (Basel) VL - 13 IS - 4 N2 - The aim of this systematic review is to investigate the effects of the use of a medium cut-off membrane (MCO) and dietary fiber on the concentration of protein-bound uremic toxins (PBUTs) and inflammatory markers in hemodialysis (HD) patients. Of 11,397 papers originally found, eight met the criteria of randomized controlled trial design. No study examined the effects of MCO membranes on PBUTs. Three studies examined the reduction in inflammatory markers with MCO membranes compared to high-flux HD membranes and showed no significant differences. Five studies of dietary fiber supplementation showed an inconclusive positive effect on PBUT levels and a significant positive effect on the reduction in inflammatory markers (interleukin-6 reduction: standardized difference in means -1.18; 95% confidence interval -1.45 to -0.9 for dietary fiber supplementation vs. control; p < 0.001). To date, no study has combined the use of an MCO membrane and fiber supplementation to reduce PBUT levels and inflammation with online hemodiafiltration as a comparator. A rationale and protocol for an interventional trial using a combination of MCO membrane dialysis and fiber supplementation to lower inflammatory markers and PBUT concentrations are presented. SN - 2072-6651 UR - https://www.unboundmedicine.com/medline/citation/33805509/Medium_Cut_Off_Dialysis_Membrane_and_Dietary_Fiber_Effects_on_Inflammation_and_Protein_Bound_Uremic_Toxins:_A_Systematic_Review_and_Protocol_for_an_Interventional_Study_ L2 - https://www.mdpi.com/resolver?pii=toxins13040244 DB - PRIME DP - Unbound Medicine ER -