HYDROLINK® is the new revolutionary dialysis membrane from TORAY. Introducing a new technology, this series offers unique antithrombogenicity allowing a dramatic reduction of anticoagulant agents use in addition to a potential improvement of intradialytic hypotension in CKD-HD patients.
Designed to reduce or avoid anticoagulant administration
By using HYDROLINK technology, proteins and molecules in patients blood surrounded by ‘adsorbed water’ come in contact with the capillary inner material conceived with outstanding hydrophilicity, leading to a water-to-water contact.
Dialysis treatment requires anticoagulant therapy, usually with unfractionated or low molecular weight heparin to prevent the clotting of the dialyzer and the extracorporeal circuit. In some patients, heparin can cause side effects such as thrombocytopenia, hyperlipidaemia or hyperkalaemia. Heparin is contraindicated in patients with active bleeding or with a high risk of bleeding.
The TRIATHRON study, a prospective randomized clinical study, was conducted with the aim of studying the anti-thrombogenic effects of HYDROLINK compared to polysulfone dialyzers. To compare the possibility of performing heparin-free dialysis, progressive heparin reduction tests were performed starting from the fourth to the eighth week, starting with 100% heparin and gradually reducing by 20% at the time to arrive at 0% at the beginning of the eighth week. In the HYDROLINK membrane treated group, 50% of patients achieved 0% heparin, while in the polysulfone membrane treated group, only 25% reached 0% heparin (p = 0.007)
Reduction of intradialytic hypotension
Intradialytic hypotension (IDH) is a frequent complication in patients undergoing dialysis therapy. Intradialytic hypotension is defined as a systolic pressure less than 100 mmHg or a decrease in systolic pressure greater than 10 mmHg or a decrease in average blood pressure of more than 30 mmHg, with or without symptoms. Intradialytic hypotension can lead to inadequate dialysis, a delay in the recovery of organ function in the event of acute kidney injury, a rapid decline in residual renal function, chronic water retention, vascular access thrombosis, increased risk of cardiovascular events and an increased risk of mortality.
A prospective multicenter study was undertaken to study the effect of HYDROLINK on IDH. Forty patients with diabetic nephropathy undergoing HD and receiving two or more treatments for IDH per month were enrolled in this study. They were stratified by the number of treatments for IDH and divided to two groups using HYDROLINK NV or conventional PS/polyethersulfone (PES) dialyzers. The number of treatments for IDH and changes in systolic blood pressure (SBP) were monitored for 6 months. The total number of treatments for IDH decreased significantly in NV group. In addition, patients using NV had significantly higher post-dialysis SBP and lower SBP during HD at sixth months compared to those in PS/PES group.