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Adsorption of Protein-Bound Uremic Toxins Using Activated Carbon through Direct Hemoperfusion in vitro.
Blood Purif. 2019; 48(3):215-222.BP

Abstract

BACKGROUND/AIMS

Accumulation of protein-bound uremic toxins (PBUTs) is associated with mortality due to various systemic disorders in patients with chronic kidney disease (CKD), especially in those undergoing dialysis treatment. The clinical outcomes of such patients could be improved by removing sufficient amounts of PBUTs; however, conventional dialysis lacks this ability. We examined the efficacy of activated carbon in adsorbing circulating PBUTs through direct hemoperfusion (DHP) in vitro.

METHODS

An in vitro blood circulating system was constructed with 8.5 mL blood circulating around a column containing activated carbon (50, 100, or 200 mg). Bovine blood containing a kind of PBUT (at the same concentration as that found in the blood of dialysis patients) and blood from hemodialysis patients (n = 8) were used. After circulation for the designated amount of time, sera were collected and the levels of PBUTs, including indoxyl sulfate (IS), p-cresyl sulfate, indole acetic acid (IAA), phenyl sulfate, and hippuric acid, were analyzed with mass spectrometry.

RESULTS

Activated carbon decreased the PBUT level in bovine blood in a dose-dependent manner (e.g., reduction rate of IS: 67.9 ± 3.8, 83.3 ± 1.9, and 94.5 ± 1.1% after 60-min circulation in columns containing 50, 100, and 200 mg activated carbon respectively). IS, PCS, and IAA were dramatically adsorbed by activated carbon from the blood of patients undergoing hemodialysis (pre vs. post 240-min reaction: IS 2.835 ± 0.876 vs. 0.455 ± 0.108 mg/dL [p < 0.01], PCS 3.208 ± 2.876 vs. 0.768 ± 0.632 mg/dL [p < 0.01], IAA 0.082 ± 0.045 vs. 0.016 ± 0.005 mg/dL [p < 0.01]).

CONCLUSION

Activated carbon effectively adsorbed blood PBUTs in vitro. DHP with activated carbon could be a promising strategy for removing circulating PBUTs from the blood of patients with CKD.

Authors+Show Affiliations

Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan, yamamots@med.niigata-u.ac.jp. Division of Blood Purification Therapy, Niigata University Medical and Dental Hospital, Niigata, Japan, yamamots@med.niigata-u.ac.jp.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.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.Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31055586

Citation

Yamamoto, Suguru, et al. "Adsorption of Protein-Bound Uremic Toxins Using Activated Carbon Through Direct Hemoperfusion in Vitro." Blood Purification, vol. 48, no. 3, 2019, pp. 215-222.
Yamamoto S, Ito T, Sato M, et al. Adsorption of Protein-Bound Uremic Toxins Using Activated Carbon through Direct Hemoperfusion in vitro. Blood Purif. 2019;48(3):215-222.
Yamamoto, S., Ito, T., Sato, M., Goto, S., Kazama, J. J., Gejyo, F., & Narita, I. (2019). Adsorption of Protein-Bound Uremic Toxins Using Activated Carbon through Direct Hemoperfusion in vitro. Blood Purification, 48(3), 215-222. https://doi.org/10.1159/000500014
Yamamoto S, et al. Adsorption of Protein-Bound Uremic Toxins Using Activated Carbon Through Direct Hemoperfusion in Vitro. Blood Purif. 2019;48(3):215-222. PubMed PMID: 31055586.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Adsorption of Protein-Bound Uremic Toxins Using Activated Carbon through Direct Hemoperfusion in vitro. AU - Yamamoto,Suguru, AU - Ito,Toru, AU - Sato,Mami, AU - Goto,Shin, AU - Kazama,Junichiro J, AU - Gejyo,Fumitake, AU - Narita,Ichiei, Y1 - 2019/05/03/ PY - 2019/01/31/received PY - 2019/03/29/accepted PY - 2019/5/6/pubmed PY - 2020/2/14/medline PY - 2019/5/6/entrez KW - Activated carbons KW - Direct hemoperfusion KW - Hemodialysis KW - Protein-bound uremic toxins SP - 215 EP - 222 JF - Blood purification JO - Blood Purif VL - 48 IS - 3 N2 - BACKGROUND/AIMS: Accumulation of protein-bound uremic toxins (PBUTs) is associated with mortality due to various systemic disorders in patients with chronic kidney disease (CKD), especially in those undergoing dialysis treatment. The clinical outcomes of such patients could be improved by removing sufficient amounts of PBUTs; however, conventional dialysis lacks this ability. We examined the efficacy of activated carbon in adsorbing circulating PBUTs through direct hemoperfusion (DHP) in vitro. METHODS: An in vitro blood circulating system was constructed with 8.5 mL blood circulating around a column containing activated carbon (50, 100, or 200 mg). Bovine blood containing a kind of PBUT (at the same concentration as that found in the blood of dialysis patients) and blood from hemodialysis patients (n = 8) were used. After circulation for the designated amount of time, sera were collected and the levels of PBUTs, including indoxyl sulfate (IS), p-cresyl sulfate, indole acetic acid (IAA), phenyl sulfate, and hippuric acid, were analyzed with mass spectrometry. RESULTS: Activated carbon decreased the PBUT level in bovine blood in a dose-dependent manner (e.g., reduction rate of IS: 67.9 ± 3.8, 83.3 ± 1.9, and 94.5 ± 1.1% after 60-min circulation in columns containing 50, 100, and 200 mg activated carbon respectively). IS, PCS, and IAA were dramatically adsorbed by activated carbon from the blood of patients undergoing hemodialysis (pre vs. post 240-min reaction: IS 2.835 ± 0.876 vs. 0.455 ± 0.108 mg/dL [p < 0.01], PCS 3.208 ± 2.876 vs. 0.768 ± 0.632 mg/dL [p < 0.01], IAA 0.082 ± 0.045 vs. 0.016 ± 0.005 mg/dL [p < 0.01]). CONCLUSION: Activated carbon effectively adsorbed blood PBUTs in vitro. DHP with activated carbon could be a promising strategy for removing circulating PBUTs from the blood of patients with CKD. SN - 1421-9735 UR - https://www.unboundmedicine.com/medline/citation/31055586/Adsorption_of_Protein_Bound_Uremic_Toxins_Using_Activated_Carbon_through_Direct_Hemoperfusion_in_vitro_ L2 - https://www.karger.com?DOI=10.1159/000500014 DB - PRIME DP - Unbound Medicine ER -