Introduction: Dialysis therapy has significantly advanced due to innovations in dialyzer technology and hemodialysis (HD) techniques, leading to improved patient quality of life. The effectiveness of dialysis treatment can be assessed by evaluating the reduction ratio (RR) of middle-molecular-weight substances, such as adiponectin and complement factor D. Objectives: To compare the clearance of adiponectin and complement factor D in patients undergoing hemodiafiltration (HDF) versus high-flux HD. Patients and Methods: This prospective case-control study included 20 HD patients. Dialyzer efficacy were evaluated during a mid-week dialysis session. The RR of both adiponectin and complement factor D was assessed by 2 different HD modalities (HDF versus HD) using two different dialyzer (FX 80 and platinum H4), with washout period 2 weeks. Quality of life was assessed using Subjective Global Assessment (SGA) score. Results: Adiponectin RR using HDF FX80 was 36.8±3.2 ng/mL compared to 22.6±3.8 ng/mL with HD FX80 (P<0. 001). Moreover, adiponectin RR using HDF H4 was 51.4±4.3 ng/mL compared to 27.1±1.9 ng/mL with HD H4 (P<0. 001). Complement factor D RR using HDF FX80 was 34.7±2.1 pg/mL compared to 19.8±2.8 pg/mL with HD FX80 (P<0.001). furthermore, complement factor D RR using HDF H4 was 52.7±5.3 pg/mL compared to 29.6±3 pg/mL using HD H4 (P<0.001). Conclusion: We concluded that, HDF using H4 dialyzer offered better removal of adiponectin and complement factor D compared to high flux HD. A difference was observed between the two high-flux dialyzers used. We also found SGA score negatively correlated with serum albumin.
El‐Sayed et al. (Thu,) studied this question.