Abstract: To compare the clinical therapeutic efficacy of cellulose triacetate (CTA) and polysulfone (PS) dialyzers in combination with sodium thiosulfate (STS) in alleviating skin pruritus symptoms among patients undergoing maintenance hemodialysis (MHD).  Methods  A total of 60 patients who received blood purification treatment and had a pruritus visual analogue scale (VAS) score ≥7 in the Second Blood Purification Center of Shengjing Hospital of China Medical University from June 2022 to June 2023 were enrolled. Based on random number allocation, patients were divided into the PS+STS group and the CTA+STS group, with 30 patients in each group. After 6 months of intervention, differences between the two groups were compared in terms of serum calcium (Ca), phosphorus (P), intact parathyroid hormone (iPTH), complement C3, immunoglobulin E (IgE), beta-2 microglobulin (β2-MG), pruritus severity, sleep quality, micro-inflammatory markers (including high-sensitivity C-reactive protein (Hs-CRP), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α)), oxidative stress markers (including superoxide dismutase (SOD), malondialdehyde (MDA), and glutathione peroxidase (GSH-Px)), overall effective rate, and adverse reactions.  Results   Compared to the PS+STS group, patients in the CTA+STS group exhibited significant reduction in serum P, C3, IgE, VAS scores for pruritus, Pittsburgh Sleep Quality Index (PSQI) scores, and micro-inflammatory markers (Hs-CRP and IL-1β) (P: t=3.045, P=0.004; C3: t=2.746, P=0.008; IgE: t=3.327, P=0.002; VAS: t=2.088, P=0.041; PSQI:        t=2.154, P=0.035; Hs-CRP: t=2.772, P=0.008; IL-1β: t=2.546, P=0.014). Additionally, oxidative stress markers (SOD, MDA and GSH-Px) improved significantly (SOD: t=2.065, P=0.043; MDA: t=2.121, P=0.038; GSH-Px: t=2.091, P=0.041), and the overall effective rate was significantly higher (Z=7.690, P=0.021).  Conclusion  Compared to PS combined with STS, CTA combined with STS can effectively reduce serum P, C3, and IgE levels in MHD patients with pruritus, improve micro-inflammatory status and oxidative stress imbalance, thereby significantly alleviating skin pruritus symptoms and ultimately enhancing patients' quality of life.

Key words: Uremic pruritus, Cellulose triacetate, Polysulfone, Sodium thiosulfate