Removal of the uremic retention solute p-Cresol using fractionated plasma separation and adsorption
Removal of the uremic retention solute p-Cresol using fractionated plasma separation and adsorption
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DOI：
10.1111/j.1525-1594.2007.00525.x
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发表时间：
2008-03-01
影响因子：
2.4
通讯作者：
Evenepoel, Pieter
中科院分区：
文献类型：
--
作者：
Meijers, Bjoern K.;Weber, Viktoria;Evenepoel, Pieter
腹膜透析和血液透析（HD）对蛋白结合的尿毒症滞留溶质（包括对甲酚）的清除有限。对甲酚主要以硫酸盐结合物（对甲苯硫酸盐[PCS]）的形式循环，与死亡率独立相关。分级血浆分离吸附（FPSA）是一种治疗肝衰竭的非生物解毒系统。尿毒症潴留溶质的FPSA清除率未知。我们研究了PCS清除FPSA，使用普罗米修斯系统。中性树脂吸附剂和阴离子交换吸附剂在体外结合PCS（还原率[RR] 37和70%）。离体，吸附剂质量去除（MR）（中位数47.5 mg）占总MR（中位数89.6 mg）的一半以上。在体内，FPSA期间的PCS RR（50%）超过高通量HD期间的RR（30%）。由于动静脉管道反复血栓形成，我们在四次入选后停止了研究。总之，FPSA是一种很有前途的技术，以提高蛋白结合尿毒症滞留溶质的清除。
Removal of protein-bound uremic retention solutes, including p-cresol, by peritoneal dialysis and hemodialysis (HD) is limited. p-Cresol, mainly circulating as sulfate conjugate (p-cresyl sulfate [PCS]), is independently associated with mortality. Fractionated plasma separation and adsorption (FPSA) is a nonbiologic detoxification system for the treatment of liver failure. The FPSA clearance of uremic retention solutes is unknown. We studied PCS clearance by FPSA, using the Prometheus system. The neutral resin adsorbent and the anion exchange adsorbent bind PCS in vitro (reduction ratios [RRs] 37 and 70%). Ex vivo, the adsorbent mass removal (MR) (median 47.5 mg) contributes more than half to total MR (median 89.6 mg). In vivo, PCS RR during FPSA (50%) exceeded the RR during high flux HD (30%). We halted the study after four inclusions due to repeated thrombosis of the arterio-venous conduit. In conclusion, FPSA is a promising technique to improve clearance of protein-bound uremic retention solutes.