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Adsorption of Protein-Bound Uremic Toxins Through Direct Hemoperfusion With Hexadecyl-Immobilized Cellulose Beads in Patients Undergoing Hemodialysis.
Artif Organs. 2018 Jan; 42(1):88-93.AO

Abstract

An accumulation of protein-bound uremic toxins (PBUTs) is one of major reasons for development of uremia-related complications. We examined the PBUT removal ability of a hexadecyl-immobilized cellulose bead (HICB)-containing column for patients undergoing hemodialysis. Adsorption of indoxyl sulfate (IS), a representative PBUT, to HICBs was examined in vitro. The HICB column was used in patients undergoing hemodialysis for direct hemoperfusion with a regular hemodialyzer. The serum IS, indole acetic acid (IAA), phenyl sulfate (PhS), and p-cresyl sulfate (PCS) levels were measured before and after passing the column. HICBs adsorbed protein-free (free) IS in a dose- and time-dependent manner in vitro (55.4 ± 1.4% adsorption of 1 millimolar, 251 µg/mL, IS for 1 h). In clinical studies, passing the HICB-containing column decreased the serum level of free IS, IAA, PhS, and PCS levels significantly (by 34.4 ± 30.0%, 34.8 ± 25.4%, 28.4 ± 18.0%, and 34.9 ± 22.1%, respectively), but not protein-bound toxins in maintenance hemodialysis patients. HICBs absorbed some amount of free PBUTs, but the clinical trial to use HICB column did not show effect to reduce serum PBUTs level in hemodialysis patients. Adsorption treatment by means of direct hemoperfusion with regular hemodialysis may become an attractive blood purification treatment to increase PBUT removal when more effective materials to adsorb PBUTs selectively will be developed.

Authors+Show Affiliations

Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. Division of Blood Purification Therapy, Niigata University Medical and Dental Hospital, Niigata, Japan.Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.Saiseikai Niigata Daini Hospital, Niigata, Japan.Omori Clinic, Niigata, Japan.Saiseikai Niigata Daini Hospital, Niigata, Japan.Santo-second Clinic, Niigata, Japan.Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.Department of Nephrology and Hypertension, Fukushima Medical University, Fukushima, Japan.Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. Niigata University of Pharmacy and Applied Life Sciences, Niigata, Japan.Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

28703401

Citation

Yamamoto, Suguru, et al. "Adsorption of Protein-Bound Uremic Toxins Through Direct Hemoperfusion With Hexadecyl-Immobilized Cellulose Beads in Patients Undergoing Hemodialysis." Artificial Organs, vol. 42, no. 1, 2018, pp. 88-93.
Yamamoto S, Sato M, Sato Y, et al. Adsorption of Protein-Bound Uremic Toxins Through Direct Hemoperfusion With Hexadecyl-Immobilized Cellulose Beads in Patients Undergoing Hemodialysis. Artif Organs. 2018;42(1):88-93.
Yamamoto, S., Sato, M., Sato, Y., Wakamatsu, T., Takahashi, Y., Iguchi, A., Omori, K., Suzuki, Y., Ei, I., Kaneko, Y., Goto, S., Kazama, J. J., Gejyo, F., & Narita, I. (2018). Adsorption of Protein-Bound Uremic Toxins Through Direct Hemoperfusion With Hexadecyl-Immobilized Cellulose Beads in Patients Undergoing Hemodialysis. Artificial Organs, 42(1), 88-93. https://doi.org/10.1111/aor.12961
Yamamoto S, et al. Adsorption of Protein-Bound Uremic Toxins Through Direct Hemoperfusion With Hexadecyl-Immobilized Cellulose Beads in Patients Undergoing Hemodialysis. Artif Organs. 2018;42(1):88-93. PubMed PMID: 28703401.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Adsorption of Protein-Bound Uremic Toxins Through Direct Hemoperfusion With Hexadecyl-Immobilized Cellulose Beads in Patients Undergoing Hemodialysis. AU - Yamamoto,Suguru, AU - Sato,Mami, AU - Sato,Yoko, AU - Wakamatsu,Takuya, AU - Takahashi,Yoshimitsu, AU - Iguchi,Akira, AU - Omori,Kentaro, AU - Suzuki,Yasushi, AU - Ei,Isei, AU - Kaneko,Yoshikatsu, AU - Goto,Shin, AU - Kazama,Junichiro J, AU - Gejyo,Fumitake, AU - Narita,Ichiei, Y1 - 2017/07/13/ PY - 2016/12/23/received PY - 2017/03/20/revised PY - 2017/04/12/accepted PY - 2017/7/14/pubmed PY - 2018/8/9/medline PY - 2017/7/14/entrez KW - -Adsorption KW - -Direct hemoperfusion KW - -Hemodialysis KW - -Hexadecyl-immobilized cellulose beads KW - Protein-bound uremic toxins SP - 88 EP - 93 JF - Artificial organs JO - Artif Organs VL - 42 IS - 1 N2 - An accumulation of protein-bound uremic toxins (PBUTs) is one of major reasons for development of uremia-related complications. We examined the PBUT removal ability of a hexadecyl-immobilized cellulose bead (HICB)-containing column for patients undergoing hemodialysis. Adsorption of indoxyl sulfate (IS), a representative PBUT, to HICBs was examined in vitro. The HICB column was used in patients undergoing hemodialysis for direct hemoperfusion with a regular hemodialyzer. The serum IS, indole acetic acid (IAA), phenyl sulfate (PhS), and p-cresyl sulfate (PCS) levels were measured before and after passing the column. HICBs adsorbed protein-free (free) IS in a dose- and time-dependent manner in vitro (55.4 ± 1.4% adsorption of 1 millimolar, 251 µg/mL, IS for 1 h). In clinical studies, passing the HICB-containing column decreased the serum level of free IS, IAA, PhS, and PCS levels significantly (by 34.4 ± 30.0%, 34.8 ± 25.4%, 28.4 ± 18.0%, and 34.9 ± 22.1%, respectively), but not protein-bound toxins in maintenance hemodialysis patients. HICBs absorbed some amount of free PBUTs, but the clinical trial to use HICB column did not show effect to reduce serum PBUTs level in hemodialysis patients. Adsorption treatment by means of direct hemoperfusion with regular hemodialysis may become an attractive blood purification treatment to increase PBUT removal when more effective materials to adsorb PBUTs selectively will be developed. SN - 1525-1594 UR - https://www.unboundmedicine.com/medline/citation/28703401/Adsorption_of_Protein_Bound_Uremic_Toxins_Through_Direct_Hemoperfusion_With_Hexadecyl_Immobilized_Cellulose_Beads_in_Patients_Undergoing_Hemodialysis_ L2 - https://doi.org/10.1111/aor.12961 DB - PRIME DP - Unbound Medicine ER -