Efficacy of HA130 Hemoadsorption in Removing Advanced Glycation End Products in Maintenance Hemodialysis Patients.

Background: Patients on maintenance hemodialysis (HD) face complications due to the accumulation of protein-bound uremic toxins, such as advanced glycation end products (AGEs), which contribute to inflammation, oxidative stress, and cardiovascular disease. Conventional HD techniques inadequately remove AGEs. This study evaluates the efficacy of the HA130 hemoadsorption cartridge combined with high-flux HD (HF-HD) in enhancing AGE removal.

Methods: This prospective, single-center study included 20 maintenance HD patients randomized into two groups: HF-HD alone (n = 10) and HF-HD plus hemoadsorption (n = 10). Blood samples were collected before and after a single session to measure carboxymethyllysine (CML), soluble RAGE (sRAGE), prolactin, and parathyroid hormone (PTH) levels. Reduction ratios (RR) were calculated, including corrected for hemoconcentration (RRc), to ensure accuracy. Statistical analyses included Mann-Whitney U and Chi-square tests.

Results: The HF-HD plus hemoadsorption group showed significantly enhanced removal of CML compared to HF-HD alone, with RRc of 64.7% [52.6-74.9] versus 39.3% [33.8-49.4], respectively (p = 0.045). Similarly, uncorrected reduction ratios demonstrated a trend favoring hemoadsorption, with values of 57.5% [45.1-70.7] versus 30.3% [19.1-44.5] (p = 0.053). Importantly, sRAGE levels were preserved in both groups (RRc: 23.4% (15.1-30.4) vs. 21.8% (16.6-31.7), p = 0.791), highlighting the safety of hemoadsorption. Other biochemical parameters, including prolactin, PTH, albumin, and electrolytes, showed no significant differences between groups. All sessions were completed without adverse events.

Conclusion: Combining hemoadsorption with HF-HD significantly enhances CML removal, as evidenced by corrected RR, without compromising protective sRAGE levels. This innovative approach offers a promising adjunctive therapy for reducing AGEs-related complications in end-stage renal disease patients. Further longitudinal studies are needed to confirm these findings and evaluate long-term outcomes.