Abstract
Hemodialysis is a widely available and well-established treatment for patients with End Stage Renal Disease (ESRD). However, although life-sustaining, patient mortality rates are very high. Several recent studies corroborated the link between dialysis patients’ outcomes and elevated levels of protein-bound uremic toxins (PBUT) that are poorly removed by conventional hemodialysis. Therefore, new treatments are needed to improve their removal. Recently, our group showed that the combination of dialysis and adsorption on one membrane, the mixed matrix membrane (MMM), can effectively remove those toxins from human plasma. However, these first MMMs were rather large in diameter and their mass transport characteristics needed improvement before application in the clinical setting. Therefore, in this study we developed a new generation of MMMs that have a smaller diameter and optimized characteristics offering superior ability in removing the PBUT indoxyl sulfate (IS) and p-cresyl sulfate (pCS) in comparison to first generation MMMs (30 and 125% respectively), as well as, a commercial dialysis membrane (more than 100% better removal).
Highlights
Suggested that the improvement in protein-bound uremic toxins (PBUT) clearance could be attributed to the maintenance of a virtually close to zero concentration of the uremic toxins at the dialysate side of the hemodialysis membranes, thereby maintaining a maximal concentration gradient, the driving force for toxin removal, across the dialyzer during the experiment
As the adsorbent material Norit A Supra was used as it has high adsorption capacity and selectivity to creatinine and PBUT19,20
It was noticed that an activated carbon loading of higher than 60% sharply increases the brittleness of the membranes
Summary
Suggested that the improvement in PBUT clearance could be attributed to the maintenance of a virtually close to zero concentration of the uremic toxins at the dialysate side of the hemodialysis membranes, thereby maintaining a maximal concentration gradient, the driving force for toxin removal, across the dialyzer during the experiment. Our first results for removal of small water-soluble toxins and PBUTs by hollow MMM were encouraging[20] These membranes were rather large (internal diameter of around 700 μm) in comparison to the hollow fibers of 200 μm currently used in clinical practice, hampering clinical implementation. These membranes had rather large pores, resulting in albumin leakage during convective treatments, which might be considered undesirable. The performance of the new membranes for removal of creatinine, a small water soluble solute, and of the IS and p-CS is evaluated and compared to first generation of MMM20 and to Fresenius F8HPS low flux dialyser membranes, currently used in clinical practice
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
