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Medium Cut-Off and High-Flux Membranes on Mineral and Bone Metabolism in Hemodialysis Patients (MBD-HD)

30. června 2026 aktualizováno: Veysel Baran TOMAR, Gazi University

Prospective Comparative Evaluation of the Effects of Medium Cut-Off and High-Flux Hemodialysis Membranes on Mineral and Bone Metabolism Biomarkers and Body Composition in Maintenance Hemodialysis Patients

This study aims to compare the effects of medium cut-off (MCO) and high-flux hemodialysis membranes on mineral and bone metabolism biomarkers in patients receiving maintenance hemodialysis. Chronic kidney disease-mineral and bone disorder (CKD-MBD) is characterized by disturbances in biomarkers such as fibroblast growth factor-23 (FGF-23) and sclerostin, which are associated with bone turnover, vascular calcification, and adverse clinical outcomes.

This is a single-center, prospective, randomized, open-label, two-sequence, two-period crossover clinical study. Thirty adult patients receiving maintenance hemodialysis will be randomized to receive either MCO membrane treatment followed by high-flux membrane treatment or the reverse sequence, with each treatment period lasting three months.

Serum FGF-23 and sclerostin levels will be measured at baseline, Month 3, and Month 6. Additional assessments will include pulse wave velocity (PWV), body composition monitoring (BCM), handgrip strength, health-related quality of life (KDQOL-36), pruritus severity (UP-Dial), and pain assessment (SF-MPQ). The study will evaluate whether MCO membranes provide additional benefits compared with conventional high-flux membranes regarding CKD-MBD-related biomarkers and patient-centered outcomes.

Přehled studie

Postavení

Zatím nenabíráme

Podmínky

Intervence / Léčba

Detailní popis

Chronic kidney disease-mineral and bone disorder (CKD-MBD) is a common complication in patients receiving maintenance hemodialysis and is associated with abnormalities in mineral metabolism, bone turnover, vascular calcification, and increased cardiovascular risk. Biomarkers such as fibroblast growth factor-23 (FGF-23) and sclerostin play important roles in the pathophysiology of CKD-MBD and have been associated with adverse clinical outcomes in patients with end-stage kidney disease.

Medium cut-off (MCO) hemodialysis membranes have been developed to enhance the removal of middle-molecular-weight uremic toxins compared with conventional high-flux membranes. Because FGF-23 and sclerostin are relatively large circulating molecules, MCO membranes may provide improved clearance and potentially influence CKD-MBD-related biological pathways.

This study is a single-center, prospective, randomized, open-label, two-sequence, two-period crossover clinical investigation conducted in maintenance hemodialysis patients. Eligible participants will be randomized in a 1:1 ratio to one of two treatment sequences. Sequence A will receive MCO hemodialysis for three months followed by high-flux hemodialysis for three months. Sequence B will receive high-flux hemodialysis for three months followed by MCO hemodialysis for three months.

Assessments will be performed at baseline, Month 3, and Month 6. Primary outcome measures include changes in serum FGF-23 and sclerostin concentrations. Secondary outcome measures include changes in pulse wave velocity (PWV), body composition parameters measured by BCM, handgrip strength, health-related quality of life (KDQOL-36), pruritus severity (UP-Dial), and pain characteristics (SF-MPQ).

Routine laboratory evaluations will be performed according to standard clinical practice. In addition, blood samples will be collected for FGF-23 and sclerostin measurements at each study visit. Safety assessments will include monitoring of adverse events, dialysis-related intolerance, and clinically significant medical events throughout the study period.

The results of this study are expected to provide evidence regarding the effects of MCO membranes on CKD-MBD-related biomarkers and patient-centered outcomes and may contribute to optimizing membrane selection strategies in maintenance hemodialysis practice.

Typ studie

Intervenční

Zápis (Odhadovaný)

30

Fáze

  • Nelze použít

Kontakty a umístění

Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.

Studijní kontakt

Studijní místa

  • Turecko (Türkiye)
    • Ankara
      • Ankara, Ankara, Turecko (Türkiye), 06500
        • Gazi University Faculty of Medicine, Department of Nephrology, Hemodialysis Unit
        • Kontakt:
        • Kontakt:

Kritéria účasti

Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.

Kritéria způsobilosti

Věk způsobilý ke studiu

  • Dospělý
  • Starší dospělý

Přijímá zdravé dobrovolníky

Ne

Popis

Inclusion Criteria:

  • Age 18 to 80 years.
  • Receiving maintenance hemodialysis for at least 6 months.
  • Clinically stable and receiving thrice-weekly hemodialysis.
  • Able to comply with study procedures, questionnaires, and scheduled assessments.
  • Able and willing to provide written informed consent.

Exclusion Criteria:

  • Acute infection at screening or enrollment.
  • Major surgery within the previous 3 months.
  • Active malignancy requiring ongoing treatment.
  • Terminal illness with limited life expectancy.
  • Physical or cognitive impairment preventing completion of study procedures or questionnaires.
  • Inability or unwillingness to provide written informed consent.

Studijní plán

Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.

Jak je studie koncipována?

Detaily designu

  • Primární účel: Léčba
  • Přidělení: Randomizované
  • Intervenční model: Crossover Assignment
  • Maskování: Žádné (otevřený štítek)

Zbraně a zásahy

Skupina účastníků / Arm
Intervence / Léčba
Experimentální: Sequence A (MCO to High-Flux)
Participants randomized to Sequence A will receive medium cut-off (MCO) hemodialysis membranes during Period 1 (Months 0-3), followed by high-flux hemodialysis membranes during Period 2 (Months 3-6). Hemodialysis will be performed three times weekly according to standard clinical practice. Serum fibroblast growth factor-23 (FGF-23), sclerostin, pulse wave velocity (PWV), body composition parameters, handgrip strength, and patient-reported outcomes will be assessed at baseline, Month 3, and Month 6.
Přístroj: Medium Cut-Off Hemodialysis Membrane
A medium cut-off (MCO) hemodialysis membrane used during maintenance hemodialysis treatment. Participants assigned to MCO treatment will receive thrice-weekly hemodialysis according to standard clinical practice. The intervention is intended to enhance the removal of middle-molecular-weight solutes and to evaluate its effects on mineral and bone metabolism biomarkers, including fibroblast growth factor-23 (FGF-23) and sclerostin, as well as body composition, vascular stiffness, and patient-reported outcomes.
Přístroj: High-Flux Hemodialysis Membrane
A conventional high-flux hemodialysis membrane used during maintenance hemodialysis treatment. Participants assigned to high-flux treatment will receive thrice-weekly hemodialysis according to standard clinical practice. This intervention serves as the comparator for evaluating the effects of medium cut-off membranes on mineral and bone metabolism biomarkers, including fibroblast growth factor-23 (FGF-23) and sclerostin, as well as body composition, vascular stiffness, and patient-reported outcomes.
Experimentální: Sequence B (High-Flux to MCO)
Participants randomized to Sequence B will receive high-flux hemodialysis membranes during Period 1 (Months 0-3), followed by medium cut-off (MCO) hemodialysis membranes during Period 2 (Months 3-6). Hemodialysis will be performed three times weekly according to standard clinical practice. Serum fibroblast growth factor-23 (FGF-23), sclerostin, pulse wave velocity (PWV), body composition parameters, handgrip strength, and patient-reported outcomes will be assessed at baseline, Month 3, and Month 6.
Přístroj: Medium Cut-Off Hemodialysis Membrane
A medium cut-off (MCO) hemodialysis membrane used during maintenance hemodialysis treatment. Participants assigned to MCO treatment will receive thrice-weekly hemodialysis according to standard clinical practice. The intervention is intended to enhance the removal of middle-molecular-weight solutes and to evaluate its effects on mineral and bone metabolism biomarkers, including fibroblast growth factor-23 (FGF-23) and sclerostin, as well as body composition, vascular stiffness, and patient-reported outcomes.
Přístroj: High-Flux Hemodialysis Membrane
A conventional high-flux hemodialysis membrane used during maintenance hemodialysis treatment. Participants assigned to high-flux treatment will receive thrice-weekly hemodialysis according to standard clinical practice. This intervention serves as the comparator for evaluating the effects of medium cut-off membranes on mineral and bone metabolism biomarkers, including fibroblast growth factor-23 (FGF-23) and sclerostin, as well as body composition, vascular stiffness, and patient-reported outcomes.

Co je měření studie?

Primární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Change in Serum Fibroblast Growth Factor-23 (FGF-23)
Časové okno: At baseline (July 2026), Month 3 (October 2026), and Month 6 (January 2027)
Change in serum fibroblast growth factor-23 (FGF-23) concentrations during treatment with medium cut-off and high-flux hemodialysis membranes. Serum FGF-23 levels will be measured using ELISA and compared between treatment periods.
At baseline (July 2026), Month 3 (October 2026), and Month 6 (January 2027)
Change in Serum Sclerostin
Časové okno: At baseline (July 2026), Month 3 (October 2026), and Month 6 (January 2027)
Change in serum sclerostin concentrations during treatment with medium cut-off and high-flux hemodialysis membranes. Serum sclerostin levels will be measured using ELISA and compared between treatment periods.
At baseline (July 2026), Month 3 (October 2026), and Month 6 (January 2027)

Sekundární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Change in Kidney Disease Quality of Life-36 (KDQOL-36) Score
Časové okno: At baseline (July 2026), Month 3 (October 2026), and Month 6 (January 2027)
Evaluation of patient-reported quality of life using the KDQOL-36 questionnaire.
At baseline (July 2026), Month 3 (October 2026), and Month 6 (January 2027)
Change in UP-Dial Pruritus Score
Časové okno: At baseline (July 2026), Month 3 (October 2026), and Month 6 (January 2027)
Evaluation of pruritus severity using the Uraemic Pruritus in Dialysis Patients (UP-Dial) scale. The UP-Dial total score ranges from 0 to 56, with higher scores indicating more severe pruritus and a worse outcome.
At baseline (July 2026), Month 3 (October 2026), and Month 6 (January 2027)
Change in Short-Form McGill Pain Questionnaire (SF-MPQ) Score
Časové okno: At baseline (July 2026), Month 3 (October 2026), and Month 6 (January 2027)
Evaluation of pain using the Short-Form McGill Pain Questionnaire (SF-MPQ) total Pain Rating Index score. The SF-MPQ total Pain Rating Index score is calculated from 15 pain descriptors, each scored from 0 to 3, resulting in a total score range of 0 to 45. Higher scores indicate greater pain severity and a worse outcome.
At baseline (July 2026), Month 3 (October 2026), and Month 6 (January 2027)
Change in Overhydration (OH)
Časové okno: At baseline (July 2026), Month 3 (October 2026), and Month 6 (January 2027)
Assessment of overhydration (OH, L) measured using the Body Composition Monitor (BCM).
At baseline (July 2026), Month 3 (October 2026), and Month 6 (January 2027)
Change in Extracellular Water to Total Body Water Ratio (ECW/TBW)
Časové okno: At baseline (July 2026), Month 3 (October 2026), and Month 6 (January 2027)
Assessment of the extracellular water to total body water ratio (ECW/TBW) using the Body Composition Monitor (BCM).
At baseline (July 2026), Month 3 (October 2026), and Month 6 (January 2027)
Change in Intracellular Water (ICW)
Časové okno: At baseline (July 2026), Month 3 (October 2026), and Month 6 (January 2027)
Assessment of intracellular water (ICW, L) using the Body Composition Monitor (BCM).
At baseline (July 2026), Month 3 (October 2026), and Month 6 (January 2027)
Change in Lean Tissue Index (LTI)
Časové okno: At baseline (July 2026), Month 3 (October 2026), and Month 6 (January 2027)
Assessment of lean tissue index (LTI, kg/m²) using the Body Composition Monitor (BCM).
At baseline (July 2026), Month 3 (October 2026), and Month 6 (January 2027)
Change in Body Cell Mass (BCM)
Časové okno: At baseline (July 2026), Month 3 (October 2026), and Month 6 (January 2027)
Assessment of body cell mass (BCM, kg) using the Body Composition Monitor.
At baseline (July 2026), Month 3 (October 2026), and Month 6 (January 2027)
Change in Pulse Wave Velocity (PWV) Measured in m/s
Časové okno: At baseline (July 2026), Month 3 (October 2026), and Month 6 (January 2027)
Pulse wave velocity (PWV) will be measured in meters per second (m/s) as a single parameter of arterial stiffness. Change in PWV from baseline to Month 3 and Month 6 will be compared between medium cut-off and high-flux hemodialysis membrane treatment periods.
At baseline (July 2026), Month 3 (October 2026), and Month 6 (January 2027)
Change in Handgrip Strength Measured by Hand Dynamometer
Časové okno: At baseline (July 2026), Month 3 (October 2026), and Month 6 (January 2027)
Handgrip strength will be measured in kilograms (kg) using a hand dynamometer. The same prespecified measurement method will be used at each study visit. Change in handgrip strength from baseline to Month 3 and Month 6 will be compared between medium cut-off and high-flux hemodialysis membrane treatment periods.
At baseline (July 2026), Month 3 (October 2026), and Month 6 (January 2027)

Spolupracovníci a vyšetřovatelé

Zde najdete lidi a organizace zapojené do této studie.

Sponzor

Gazi University

Spolupracovníci

Nipro Medical Corporation

Publikace a užitečné odkazy

Osoba odpovědná za zadávání informací o studiu tyto publikace poskytuje dobrovolně. Mohou se týkat čehokoli, co souvisí se studiem.

Obecné publikace

Termíny studijních záznamů

Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.

Hlavní termíny studia

Začátek studia (Odhadovaný)

1. července 2026

Primární dokončení (Odhadovaný)

1. ledna 2027

Dokončení studie (Odhadovaný)

1. ledna 2027

Termíny zápisu do studia

První předloženo

24. června 2026

První předloženo, které splnilo kritéria kontroly kvality

30. června 2026

První zveřejněno (Aktuální)

6. července 2026

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Aktuální)

6. července 2026

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

30. června 2026

Naposledy ověřeno

1. června 2026

Více informací

Termíny související s touto studií

Klíčová slova

Další relevantní podmínky MeSH

Další identifikační čísla studie

  • GAZI-HD-MCO-MBD-2026

Plán pro data jednotlivých účastníků (IPD)

Plánujete sdílet data jednotlivých účastníků (IPD)?

NE

Popis plánu IPD

Individual participant data (IPD) are not planned to be shared publicly. The study involves a limited number of participants from a single center, and data will be retained and managed in accordance with institutional policies, ethical requirements, and applicable data protection regulations.

Informace o lécích a zařízeních, studijní dokumenty

Studuje lékový produkt regulovaný americkým FDA

Ne

Studuje produkt zařízení regulovaný americkým úřadem FDA

Ne

Tyto informace byly beze změn načteny přímo z webu clinicaltrials.gov. Máte-li jakékoli požadavky na změnu, odstranění nebo aktualizaci podrobností studie, kontaktujte prosím register@clinicaltrials.gov. Jakmile bude změna implementována na clinicaltrials.gov, bude automaticky aktualizována i na našem webu .

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