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Increasing the removal of protein-bound uremic toxins by liposome-supported hemodialysis.
Artif Organs. 2019 May; 43(5):490-503.AO

Abstract

Protein-bound uremic toxins (PBUTs) accumulate at high plasma levels and cause various deleterious effects in end-stage renal disease patients because their removal by conventional hemodialysis is severely limited by their low free-fraction levels in plasma. Here, we assessed the extent to which solute removal can be increased by adding liposomes to the dialysate. The uptake of liposomes by direct incubation in vitro showed an obvious dose-response relationship for p-cresyl sulfate (PCS) and indoxyl sulfate (IS) but not for hippuric acid (HA). The percent removal of both PCS and IS but not of HA was gradually increased with the increased concentration of liposomes in a rapid equilibrium dialysis setup. In vitro closed circulation showed that adding liposomes to the dialysate markedly increased the dialysances of PBUTs without greatly altering that of urea and creatinine. In vivo experiments in uremic rats demonstrated that adding liposomes to the dialysate resulted in higher reduction ratios (RRs) and more total solute removal (TSR) for several PBUTs compared to the conventional dialysate, which was approximately similar to the addition of bovine serum albumin to the dialysate. These findings highlight that as an adjunct to conventional hemodialysis, addition of liposomes to the dialysate could significantly improve the removal of protein-bound uremic solutes without greatly altering the removal of small, water-soluble solutes.

Authors+Show Affiliations

Division of Nephrology & Unit of Critical Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.Division of Nephrology & Unit of Critical Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China. The State Key Laboratory of Bioreactor Engineering, Key Laboratory for Ultrafine Materials of Ministry of Education, East China University of Science & Technology, Shanghai, China.Division of Nephrology & Unit of Critical Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.Division of Nephrology & Unit of Critical Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.Division of Nephrology & Unit of Critical Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.Division of Nephrology & Unit of Critical Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.Division of Nephrology & Unit of Critical Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.The State Key Laboratory of Bioreactor Engineering, Key Laboratory for Ultrafine Materials of Ministry of Education, East China University of Science & Technology, Shanghai, China.Division of Nephrology & Unit of Critical Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30375673

Citation

Shi, Yuanyuan, et al. "Increasing the Removal of Protein-bound Uremic Toxins By Liposome-supported Hemodialysis." Artificial Organs, vol. 43, no. 5, 2019, pp. 490-503.
Shi Y, Wang Y, Ma S, et al. Increasing the removal of protein-bound uremic toxins by liposome-supported hemodialysis. Artif Organs. 2019;43(5):490-503.
Shi, Y., Wang, Y., Ma, S., Liu, T., Tian, H., Zhu, Q., Wang, W., Li, Y., & Ding, F. (2019). Increasing the removal of protein-bound uremic toxins by liposome-supported hemodialysis. Artificial Organs, 43(5), 490-503. https://doi.org/10.1111/aor.13383
Shi Y, et al. Increasing the Removal of Protein-bound Uremic Toxins By Liposome-supported Hemodialysis. Artif Organs. 2019;43(5):490-503. PubMed PMID: 30375673.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increasing the removal of protein-bound uremic toxins by liposome-supported hemodialysis. AU - Shi,Yuanyuan, AU - Wang,Yifeng, AU - Ma,Shuai, AU - Liu,Tingyan, AU - Tian,Huajun, AU - Zhu,Qiuyu, AU - Wang,Wenji, AU - Li,Yulin, AU - Ding,Feng, Y1 - 2018/12/12/ PY - 2018/06/12/received PY - 2018/10/13/revised PY - 2018/10/17/accepted PY - 2018/10/31/pubmed PY - 2019/8/29/medline PY - 2018/10/31/entrez KW - end-stage renal disease KW - hemodialysis KW - liposomes KW - protein-bound uremic toxins SP - 490 EP - 503 JF - Artificial organs JO - Artif Organs VL - 43 IS - 5 N2 - Protein-bound uremic toxins (PBUTs) accumulate at high plasma levels and cause various deleterious effects in end-stage renal disease patients because their removal by conventional hemodialysis is severely limited by their low free-fraction levels in plasma. Here, we assessed the extent to which solute removal can be increased by adding liposomes to the dialysate. The uptake of liposomes by direct incubation in vitro showed an obvious dose-response relationship for p-cresyl sulfate (PCS) and indoxyl sulfate (IS) but not for hippuric acid (HA). The percent removal of both PCS and IS but not of HA was gradually increased with the increased concentration of liposomes in a rapid equilibrium dialysis setup. In vitro closed circulation showed that adding liposomes to the dialysate markedly increased the dialysances of PBUTs without greatly altering that of urea and creatinine. In vivo experiments in uremic rats demonstrated that adding liposomes to the dialysate resulted in higher reduction ratios (RRs) and more total solute removal (TSR) for several PBUTs compared to the conventional dialysate, which was approximately similar to the addition of bovine serum albumin to the dialysate. These findings highlight that as an adjunct to conventional hemodialysis, addition of liposomes to the dialysate could significantly improve the removal of protein-bound uremic solutes without greatly altering the removal of small, water-soluble solutes. SN - 1525-1594 UR - https://www.unboundmedicine.com/medline/citation/30375673/Increasing_the_removal_of_protein_bound_uremic_toxins_by_liposome_supported_hemodialysis_ DB - PRIME DP - Unbound Medicine ER -