***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: This biocompatibility of the new cellulosic membrane hemophane ( HE ) is compared to that of cuprophane ( CU ) in ten maintenance hemodialysis ( HD ) patients dialyzed on the two types of membranes in r and omized order , under otherwise similar technical conditions .  Total white blood cell ( WBC ) and differential counts , blood concentrations of C3a , and C3d and histamine are determined at start of dialysis ( TO ) and 10 , 20 and 180 minutes thereafter . HE is distinct from CU in exerting a minor effect on the generation of C3a , a minor drop of leucocytes during the course of dialysis ( P less than 0.01 ) and also by a lesser increase in blood histamine concentration ( P less than 0.05 ) . Histamine liberation is observed on CU together with the generation of anaphylotoxin C3 and with a diminution of circulating basopolymorpho-nuclear cells . According to the variations observed for these three parameters ( C3a , leucocytosis and blood histamine concentration ) , HE appears as being more biocompatible than CU Ultrafiltration , diffusion , osmotic shifts , blood-membrane interactions , and psychological factors have all been implicated in the pathogenesis of  postdialysis fatigue ( PDF ) .  To identify responsible factors , we performed a prospect i ve , r and omized , crossover analysis of fatigue scores ( scale , 0 to 4 ) in 12 maintenance hemodialysis subjects with PDF .  Fatigue scores were evaluated on nondialysis days ( baseline ) and after the following procedures on midweek treatment days : st and ard dialysis using either a 135- to 140-mEq/L sodium bath ( routine hemodialysis ) or a 150- to 155-mEq/L sodium bath ( hypernatric hemodialysis ) ; isolated ultrafiltration ; isolated diffusion ; and sham procedures with ( isolated membrane ) or without ( recirculation ) exposure to a dialysis membrane .  Maximal fatigue scores are expressed as mean and 95 % confidence intervals ( CIs ) . The highest scores were recorded by patients who had just undergone routine hemodialysis  ( mean score , 2 . 6 ; 95 % CI , 1.7 to 3.4 ) , isolated ultrafiltration ( mean score , 2.1 ; 95 % CI , 1.3 to 2.9 ) , and isolated diffusion ( mean score , 2.4 ; 95 % CI , 1.5 to 3.2 ) . There were no significant differences in fatigue scores between baseline periods and isolated membrane and recirculation procedures ( mean score , 1.3 ; 95 % CI , 0.4 to 2.2 ) . Fatigue scores after hypernatric hemodialysis occupied an intermediate position ( mean score , 1.7 ; 95 % CI , 0.8 to 2.6 ) . These results suggest that rapid hydraulic and molecular flux have a greater role in the pathogenesis of PDF than psychological stress and blood-membrane interactions . Use of a high-sodium bath may ameliorate PDF . We conclude that appropriate adjustments in both ultrafiltration and sodium profiling remain the most important means for controlling PDF in patients on short- duration hemodialysis There is increasing evidence that the biochemical and cellular phenomena induced by blood/ membrane/dialysate interactions contribute to dialysis-related intradialytic and long-term complications . However , there is a lack of large , prospect i ve , r and omized trials comparing biocompatible and bioincompatible membranes , and convective and diffusive treatment modalities . The primary aim of this prospect i ve , r and omized trial was to evaluate whether the use of polysulfone membrane with bicarbonate dialysate offers any advantage ( in terms of treatment tolerance , nutritional parameters and pre-treatment beta-microglobulin levels ) over a traditional membrane ( Cuprophan ) . A secondary aim was to assess whether the use of more sophisticated methods consisting of a biocompatible synthetic membrane with different hydraulic permeability at different ultrafiltration rate ( high-flux hemodialysis and hemodiafiltration ) offers any further advantages . Seventy-one Centers were involved and stratified according to the availability of only the first two or all four of the following techniques : Cuprophan hemodialysis ( Cu-HD ) , low-flux polysulfone hemodialysis ( LfPS-HD ) , high-flux polysulfone high-flux hemodialysis ( HfPS-HD ) , and high-flux polysulfone hemodiafiltration ( HfPS-HDF ) .  The 380 eligible patients were r and omized to one of the two or four treatments ( 132 to Cu-HD , 147 to LfPS-HD , 51 to HfPS-HD and 50 to HfPS-HDF ) . The follow-up was 24 months . No statistical difference was observed in the algebraic sum of the end points between bicarbonate dialysis with Cuprophan or with low-flux polysulfone , or among the four dialysis methods under evaluation . There was a significant decrease in pre-dialysis plasma beta 2-microglobulin levels in high-flux dialysis of 9.04 + /- 10.46 mg/liter ( 23 % ) and in hemodiafiltration of 6.35 + /- 12.28 mg/liter ( 16 % ) , both using high-flux polysulfone membrane in comparison with Cuprophan and low-flux polysulfone membranes ( P = 0.032 ) . The significant decrease in pre-dialysis plasma beta 2-microglobulin levels could have a clinical impact when one considers that beta 2-microglobulin accumulation and amyloidosis are important long-term dialysis-related complications BACKGROUND Hyperhomocysteinaemia is a putative risk factor for atherothrombotic cardiovascular disease in the haemodialysis population .  High-dose vitamin B therapy does not entirely normalize elevated plasma total homocysteine ( tHcy ) levels in haemodialysis patients . Alternative therapies to reduce tHcy further are therefore required . Modifications of the dialysis regimen may result in a better removal of Hcy . We examined the effect of dialyser membrane pore size on tHcy levels in vitamin-replete chronic haemodialysis patients . METHODS Forty-five haemodialysis patients were dialysed during 4 weeks with a low-flux , a high-flux and a super-flux membrane , in r and om order . Pre-dialysis  tHcy  was determined at baseline and every 4 weeks . In 18 patients , plasma tHcy before and after dialysis and dialysate tHcy concentrations were measured . RESULTS Pre-dialysis tHcy decreased significantly during 4 weeks super-flux dialysis ( -14.6 + /- 2.8 % ) , whereas it remained stable during high-flux ( + 0.5 + /- 2.4 % ) and low-flux dialysis ( + 1.7 + /- 3.2 % ) . The homocysteine reduction ratio was not different for the three membranes : 0.39 + /- 0.03 for the super-flux , 0.47 + /- 0.02 for the high-flux and 0.39 + /- 0.02 for the low-flux dialyser . The amount of Hcy recovered in the dialysate during a single dialysis session was also similar : 117.5 + /- 3.6 micro mol during super-flux , 95.3 + /- 11.5 micro mol during high-flux and 116.5 + /- 11.6 micro mol during low-flux dialysis . CONCLUSION Super-flux dialysis significantly lowers tHcy in chronic haemodialysis patients . Improved removal of middle-molecule uraemic toxins with inhibitory effects on Hcy-metabolizing enzymes , rather than better dialytic clearance of Hcy itself , may explain the beneficial effect of the super-flux membrane The influence of dialyzer membrane on the morbidity and mortality of patients with acute renal failure remains a matter of debate . The aim of the prospect i ve r and omized clinical study was to assess the influence of the flux of a synthetic dialyzer membrane on patients ' survival rate , restitution of renal function , and duration of hemodialysis treatment  of patients with acute renal failure as a part of multiorgan failure . Seventy-two patients treated in intensive care units of the University Medical Center Ljubljana were r and omized according to the dialyzer used throughout the duration of hemodialysis treatment . There were 38 patients in the low-flux group ( dialyzer F6 , low-flux polysuphone , Fresenius , Bad Homburg , Germany ) and 34 patients in the high-flux group ( dialyzer Filtral 12 , sulphonated high-flux polyacrylonitrile , Hospal , Industrie Meyzieu , France ) . Both groups were balanced in terms of sex , age , APACHE II score , oliguria before dialysis , cause of acute renal failure , inotropic support , mechanical ventilation , and the number of failing organs . The patients ' survival rate was 18.7 % in the low-flux group and 20.6 % in the high-flux group . Ten patients ( 26.3 % ) recovered their renal function in the low-flux group and 8 ( 23.5 % ) in the high-flux group . Hemodialysis treatment lasted 11.2 days in the low-flux and 10.7 days in the high-flux group . An analysis of subgroups with a lower mortality rate ( subgroup of patients without oliguria and subgroup of patients with less than 4 failed organ systems ) did not show significant differences between the low-flux and high-flux groups in terms of survival rate , recovery of renal function , and duration of hemodialysis treatment . In conclusion , no significant differences were found in the results of low-flux versus high-flux synthetic membrane dialyzer treatment in patients with acute renal failure as a part of multiorgan failure in terms of survival rate , recovery of renal function , incidence of oliguria during hemodialysis , and duration of hemodialysis treatment . The number of failing organs seems to be the most important single factor determining the survival of patients with acute renal failure as a part of multiorgan failure In order to improve the biochemical reactivity of the cellulose polymer , which is mainly attributed to the presence of surface hydroxyl groups , derivatized cellulosic membranes have been engineered replacing or masking some or all of the hydroxyl groups in the manufacturing process of the membrane . The present study was set up to analyze both biocompatibility and functional performance of two different derivatized cellulosic membranes ( cellulose diacetate ; polyethylene glycol , PEG , acid-grafted cellulose ) as compared to a synthetic membrane ( polymethylmethacrylate , PMMA ) . Cellulose diacetate is prepared by substituting hydroxyl groups with acetyl groups ; PEG cellulose is obtained by grafting PEG chains onto the cellulosic polymer with a smaller amount of substitution than cellulose diacetate . While the three dialyzers provided similar urea and creatinine removal , the dialyzer containing cellulose diacetate showed a reduced ability to remove β2-microglobulin compared to that containing PEG cellulose or PMMA . A transient reduction in leukocyte count was observed for both derivatized cellulosic membranes . The neutrophil and monocyte counts throughout the entire dialysis session showed a closer parallelism with the cellular expression of the adhesive receptor CD15s ( sialyl-Lewis x molecole ) than with CD11b/CD18 expression . Platelet activation , as indicated by the percentage of cells expressing the activation markers CD62P ( P-selectin ) and CD63 ( gp53 ) , occurred with all membranes at 15 min of dialysis and also with PMMA at 30 min . An increased formation of platelet-neutrophil and platelet-monocyte coaggregates was found at 15 and 30 min during dialysis with cellulose diacetate and PMMA but not with PEG cellulose . Generally in concomitance with the increase in platelet-neutrophil coaggregates , an increased hydrogen peroxide production by neutrophils occurred . Our results indicate that derivatizing cellulose may represent a useful approach to improve the biocompatibility of the cellulose polymer , though some homeostatic reactions remain activated . Our results also indicate that there may be a great variability in the biocompatibility profile of derivatized cellulosic membranes which most likely stem from the different type of structural modification rather than from the degree of hydroxyl group replacement Abstract Background : Following the introduction of modified cellulosic and then synthetic membrane dialyzers , it was realized that the dialyzer bio-incompatibility depends on the membrane composition . We design ed a prospect i ve , r and omized , cohort study of 6 months to determine several parameters of biocompatibility in maintenance hemodialysis ( MHD ) patients treated with four different membrane dialyzers . Methods : There were 60 MHD patients enrolled in the study . In baseline , synthetic low-flux dialyzer , polysulfone ( PS ) membrane was used in all patients for at least 3 months . Then the patients were r and omly divided into three groups according to different dialyzer membranes . Synthetic high-flux dialyzer group , ployethersulfone membrane , cellulose triacetate ( CTA ) high-flux membrane , and synthetic low-flux dialyzer , polymethylmethacrylate ( PMMA ) membrane were used in 6 months . A new dialyzer was used for each study treatment , and there was 
    Output:
    
High-flux haemodialysis may reduce cardiovascular mortality in people requiring haemodialysis by about 15 % .