Prospective multicenter randomized cross-over study Number of patients : 32 (8 patients per group) Obtain objectives data to advise each hemodialyzer according to dialysis treatment and patient profile. To evaluate the different hemodialyzers and judge their extraction performances in HD and post HDF. Evaluation of the biocompatibility of the hemodialyzers and the patients' inflammatory status.
Medical devices studied : * Leoceed 21HX, hemodialyzer, High permeability PS membrane 2,1 m² , made by Nx Stage in Germany * Polypure 22S, hemodialyzer, High permeability PS membrane 2,2 m² , made by Allmed in Germany * VIE 21A hemodialyzer, High permeability PS membrane 2,1 m² coated in vitamin E, made by Asahi Kasei Medical in Japan * Rexsys 27H, hemodialyzer , High permeability PES membrane 2,7 m² , made by Medica in Italia These hemodialyzers are EC marked and are used in their own indications. Schema Details of the cross-over plan : 8 patients will be treated successively with the 4 hemodialyzers. Patients will be treated with the dialyzer "test" for the two first sessions of the week. During the last dialysis session of each week, only their usual dialyzer will be used as wash-out. A randomization will define the order of use of the dialyzers in the 4 centers. This order will be identical in a center. Number of patients : 32 (8 patients per center (4 centers)) Duration : One week per dialyzer
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
32
polysulfon membrane coated with vitamin E
polyethersulfon membrane with large surface area : 2,7m²
polyslfon membrane with gamma sterilization
AIDER-Lapeyronie
Montpellier, France
Evaluation of middle molecules extraction
Measurements of β 2 microglobulin (11,8kDa), myoglobin (17kDa), Beta Trace (21kDa), Free immunoglobulin light chains Kappa (23kDa), myostatin (40kDa), glycoprotein orosomucoïd (44kDa)
Time frame: one week per dialyzer per patient
Extraction of uremic toxins
* Urea * Creatinin * inorganic phosphates
Time frame: one week per dialyzer per patient
Biocompatibility assessment
* Anaphylatoxins (C3a, C5a) during the session (T0, T15, Tend) * TNF-α and IL-6 (T0 et Tend)
Time frame: one week per dialyzer per patient
Monitoring of Nutrition status
Quantification of the albumin loss in the used dialysate (1 center) during the middle session of the week for each dialyzer tested per patient, i.e 4 times/patient. 2 analysis modalities will be used: " pull and push " syringe Plastipak BD 50mL or collection of the whole dialysate in a 200 L tank Dosage Albumin et pre-albumin before dialysis session
Time frame: one week per dialyzer per patient
Handling of the devices
\- Evaluation of the priming and recovery for each dialysis session
Time frame: one week per dialyzer per patient
Dialysis adequacy evaluation
Calculation of KT/V
Time frame: one week per dialyzer per patient
Session tolerance
All secondary troubles will be noted: cramps, nauseas, hypotension…
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polysulfon membrane with steam sterilization
Time frame: one week per dialyzer per patient
Parameters inflammation
CRP (mg/l)
Time frame: one week per dialyzer per patient
Parameters inflammation
\- Calcul of PINI = \[CRP(mg/l) x Orosomucoïd (mg/l)\] / \[Albumin(g/l) x Pre-albumin(mg/l)\]
Time frame: one week per dialyzer per patient