Expanded Hemodialysis: Mechanisms and Equipment.

Clinical outcomes in hemodialysis remain suboptimal, and it is imperative to make any effort to improve the quality of life of dialysis patients. Unsatisfactory results have been correlated with the accumulation of uremic retention products in the middle- to high-molecular-weight range inadequately removed by current dialytic techniques. These toxins cause and worsen inflammation, immune dysfunction, and various pathological effects. This results in high morbidity and mortality with unacceptable rates of cardiovascular events, accelerated atherosclerosis, infection, and multiple organ dysfunction. Expanded hemodialysis (HDx) with a modern medium cut-off (MCO) membrane, which closely mimics the native kidney, significantly improves removal of such uremic toxins. Current evidence has shown that the safety, simplicity, superior performance, and efficacy of HDx with the MCO membrane translate to improved clinical outcomes.