Abstract: Objective To compare the outcome of acute kidney injury (AKI) patients using dialyzers with different membranes, and to estimate the clinical significance of membrane permeability by comparing the efficacies of high-flux membrane and low-flux membrane dialyzers. Methods This prospective, randomized, single-centered study included 102 AKI patients treated with hemodialysis (HD). Patients were stratified according to age, gender, and APACHE II score, and then randomized into three dialysis membrane groups: low- flux polysulfone group, high- flux polysulfone group, and modified cellulose diacetate group. Results Baseline characteristics were similar among the 3 groups. All-cause mortality by day 80 was 41.1% (14/34) in the modified cellulose diacetate group, 58.8% (20/34) in the low-flux polysulfone group, and 61.8% (21/34) in the high-flux polysulfone group. Survival rate was significant different among the three groups (multivariate Cox's proportional hazards model, HR 0.781, 95% CI 0.621~0.827, P=0.028), while the period necessary for renal function recovery (P=0.852), the flux of the membrane (HR 0.856, 95% CI 0.432～1.121, P=0.745), and the number of dialysis sessions required before recovery (P=0.764) had no differences among the three groups. Conclusions The survival rate was significantly different in AKI patients using modified cellulose diacetate membrane dialyzer and those using more biocompatible high-flux or low-flux polysulfone membrane dialyzers, while their outcomes were not influenced by the flux of the membrane.

Key words: haemodialysis, acute kidney injury, biocompatibility, survival