Abstract
More than three million patients are treated for kidney failure world-wide. Haemodialysis, the most commonly used treatment, requires large amounts of water and generates mountains of non-recyclable plastic waste. To improve the environmental footprint, dialysis treatments need to develop absorbents to regenerate the waste dialysate. Whereas conventional dialysis clears water-soluble toxins, it is not so effective in clearing protein-bound uraemic toxins (PBUTs), such as indoxyl sulfate (IS). Thus, developing absorption devices to remove both water-soluble toxins and PBUTs would be advantageous. Vapour induced phase separation (VIPS) has been used in this work to produce polycaprolactone/chitosan (PCL/CS) composite symmetric porous monoliths with extra porous carbon additives to increase creatinine and albumin-bound IS absorption. Moreover, these easy-to-fabricate porous monoliths can be formed into the required geometry. The PCL/CS porous monoliths absorbed 436 μg/g of albumin-bound IS and 2865 μg/g of creatinine in a single-pass perfusion model within 1 h. This porous PCL/CS monolith could potentially be used to absorb uraemic toxins, including PBUTs, and thus allow the regeneration of waste dialysate and the development of a new generation of environmentally sustainable dialysis treatments, including wearable devices.
Highlights
IntroductionPublisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations
Whereas the HD is very effective in clearing small water-soluble uraemic toxins, the HD is much less effective in clearing protein-bound uraemic toxins (PBUTs) [1], with reported clearances of the PBUT indoxyl sulfate (IS) of 10–15 mL/min compared to a urea clearance of 200 mL/min
We report the fabrication of a polycaprolactone/chitosan (PCL/CS) composite based on Vapour induced phase separation (VIPS) mechanism to form a sponge-like PCL/CS porous monolith as a single-use absorbent for uraemic toxin sorption
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. World-wide more than three million patients with chronic kidney disease (CKD). Receive renal replacement therapy, with the great majority treated by haemodialysis (HD). Whereas the HD is very effective in clearing small water-soluble uraemic toxins, the HD is much less effective in clearing protein-bound uraemic toxins (PBUTs) [1], with reported clearances of the PBUT indoxyl sulfate (IS) of 10–15 mL/min compared to a urea clearance of 200 mL/min. PBUTs accumulate with progressive CKD [1,2,3] and have been observed to increase the risk of cardiovascular disease [4,5,6,7]. As conventional dialysers do not effectively remove these PBUTs, newer biomaterials and designs are required
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