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Can J Kidney Health Dis
Can J Kidney Health Dis
CJK
spcjk
Canadian Journal of Kidney Health and Disease
2054-3581
SAGE Publications Sage CA: Los Angeles, CA

10.1177/20543581241278843
10.1177_20543581241278843
Letter to the Editor
Letter to the Editor in Response to the Article “Clinical Outcomes With Medium Cut-Off Versus High-Flux Hemodialysis Membranes: A Systematic Review and Meta-Analysis”
Altiparmak Mehmet Riza 1
https://orcid.org/0000-0002-8146-6966
Yalin Serkan Feyyaz 2
1 Department of Nephrology, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
2 Department of Nephrology, Kartal Dr. Lütfi Kırdar City Hospital, Istanbul, Turkey
Serkan Feyyaz Yalin, Caferaga mah. Acar sok. 6/8 Moda, Kadikoy, Istanbul 34890, Turkey. Email: serkanfyalin@yahoo.com
10 9 2024
2024
11 20543581241278843© The Author(s) 2024
2024
Canadian Society of Nephrology, unless otherwise noted. Manuscript content on this site is licensed under Creative Commons Licenses
https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
cover-dateJanuary-December 2024
typesetterts1
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pmcDear Sir,

Dr Kandi and colleagues reported clinical outcomes with medium cut-off (MCO) versus high-flux hemodialysis membranes using 22 studies (6 randomized and 16 nonrandomized studies). The authors concluded with predominantly moderate certainty that MCO dialyzer improves several patient-important outcomes. However, we have some concerns regarding the results of the study. 1

First, the authors stated that MCO dialysis likely reduces pruritis, with mean difference 4.38 lower compared with high-flux dialysis in page 11 and in table 2 on page 6. Whereas, regarding reference of this data, mean difference is lower than 4.38 between 2 membranes (MCO membrane: 6.92 ± 5.98 vs high-flux membrane: 9.92 ± 8.23). 2 In addition, there is no significant difference in pruritis between 2 types of membranes (P: .152). In conclusion, it is not possible to conclude that MCO dialysis likely reduces pruritis.

Second, in table 2 on page 6 and in page 11, the authors stated that MCO dialysis reduced recovery time by –420 minutes (high-flux membrane: 600 minutes vs MCO membrane: 180 minutes). However, in reference of this data, the median recovery is 210 minutes initially and then 105 minutes at 12th month. 3 The authors possibly used 25th and 75th percentile values in figure 1 on page 3 for calculating the difference between recovery times of 2 types of membranes. In conclusion, it is not possible to conclude that MCO dialysis reduced recovery time by –420 minutes.

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding: The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD: Serkan Feyyaz Yalin https://orcid.org/0000-0002-8146-6966
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References

1 Kandi M Brignardello-Petersen R Couban R Wu C Nesrallah G. Clinical outcomes with medium cut-off versus high-flux hemodialysis membranes: a systematic review and meta-analysis. Can J Kidney Health Dis. 2022;9 :1-16. doi:10.1177/20543581211067087.
2 Lim JH Park Y Yook JM , et al . Randomized controlled trial of medium cut-off versus high-flux dialyzers on quality of life outcomes in maintenance hemodialysis patients. Sci Rep. 2020;10 (1 ):7780. doi:10.1038/s41598-020-64622-z.32385307
3 Bolton S Gair R Nilsson LG Matthews M Stewart L McCullagh N. Clinical assessment of dialysis recovery time and symptom burden: impact of switching hemodialysis therapy mode. Patient Relat Outcome Meas. 2021;12 :315-321. doi:10.2147/PROM.S325016.34764715
