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논문분류	춘계학술대회 초록집
제목	Comparative Inflammatory Responses Between Expanded Hemodialysis Using a Medium Cut-Off Dialyzer (MCO+HDX) and Online Hemodiafiltration (OL-HDF): Insights From Microparticle Induction and Neutrophil Activation
저자	Awirut Charoensappakit
출판정보	2026; 2026(1):
키워드	Hemodialysis, Inflammation, Microparticles, Neutrophils
초록	Objectives: Although various hemodialysis (HD) modalities have demonstrated effective removal of uremic toxins, their differential impacts on systemic inflammatory mediators remain less well characterized. This study compared expanded hemodialysis using a medium cut-off dialyzer (MCO+HDX) with online hemodiafiltration (OL-HDF) in terms of uremic toxin removal and their abilities to induce pro-inflammatory responses. Methods: A randomized crossover study involving 12 maintenance HD patients, who sequentially received MCO+HDX and OL-HDF with a washout period were conducted. Circulating microparticles (MPs) and neutrophil activation were measured pre- and post-dialysis. Results: Uremic toxin removal was comparable between the two modalities. However, OL-HDF significantly increased the levels of MPs post-dialysis, predominantly derived from platelets and neutrophils. MPs from both modalities exacerbated dysfunction in human coronary artery endothelial cells (HCAECs) in vitro. In addition, OL-HDF enhanced neutrophil activation post-dialysis, as demonstrated by increased CD11b expression and elevated plasma citrullinated histone H3 levels. These findings suggest that OL-HDF promotes stronger MP generation and neutrophil activation than MCO+HDX, potentially linked to higher transmembrane pressures. Conclusion: Beyond uremic toxin clearance, HD modality–specific differences in MP release and neutrophil activation may contribute to endothelial injury and systemic inflammation. Recognition of these effects may aid in refining modality selection to improve long-term patient outcomes.
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