Plasma Flow Rate Research Articles

Renal functional reserve and renal hemodynamics in hypertensive patients

The renal functional reserve (RFR) is the ability of the kidneys to increase renal plasma flow and glomerular filtration rate (GFR) in response to protein intake. It is a measure of functional and anatomic integrity of nephrons. It is not known what relation between RFR and kidney Doppler parameters. We aimed to study the relation between the RFR and renal hemodynamic parameters in hypertensive patients with and without nephropathy who had normal kidney function. Twenty-four hypertensive subjects with nephropathy (HTN-n, n = 10) and hypertension without nephropathy (HTN, n = 14) were included in the study. Control group included 11 healthy subjects. Baseline GFR (GFR1) and GFR after intake of egg protein 1 mg/kg of body weight were determined (GFR2). RFR was calculated by the following formula: (GFR2-GFR1)/GFR1 × 100%. Doppler ultrasonography was performed. Arterial blood pressure (BP), body mass index (BMI), and estimated GFR were also recorded. HTN and HTN-n groups had impaired levels of RFR compared with controls (p < 0.05), significantly decreased value of flow velocity parameters (Vmax, Vmin), and increased RRI compared with controls. There was significant negative correlation of RFR with blood pressure levels (sBP, r = −0.435, p = 0.009; dBP, r = −0.504, p = 0.002), RRI (r = −0.456, p = 0.008), micro albuminuria (MAU, r = −0.366, p = 0.031) and positive correlation with Vmax and Vmin (r = 0.556, p = 0.001 and r = 0.643, respectively, p < 0.001). Linear regression showed that RRI and MAU were independent predictors of decreased RFR. RFR is lower in hypertensive patients despite near-normal level of kidney function and is related to particular level of BP. RRI and MAU were independent predictors of decreased RFR.

Gas and plasma dynamics of RF discharge jet of low pressure in a vacuum chamber with flat electrodes and inside tube, influence of RF discharge on the steel surface parameters

Researches results of the characteristics of the RF discharge jet of low pressure and the discharge influence on the surface modification of high speed and structural steels are introduced in the article. Gas dynamics, power and energy parameters of the RF low pressure discharge flow in the discharge chamber and the electrode gap are studied in the presence of the materials. Plasma flow rate, discharge power, the concentration of electrons, the density of RF power, the ion current density, and the energy of the ions bombarding the surface materials are considered for the definition of basic properties crucial for the process of surface modification of materials as they were put in the plasma jet. The influence of the workpiece and effect of products complex configuration on the RF discharge jet of low pressure is defined. The correlation of the input parameters of the plasma unit on the characteristics of the discharge is established.

Renal resistance and long-term blood pressure in individuals genetically predisposed for essential hypertension: 10-year follow-up of the Danish Hypertension Prevention Project.

Young individuals genetically predisposed for essential hypertension have increased renal vascular resistance. We evaluated whether 1 year of angiotensin II receptor blockade decreases afferent arteriolar resistance (RA) and induces a sustained blood pressure (BP) reduction during a 10-year follow-up period in offspring of parents both diagnosed with essential hypertension. Based on renal plasma flow (p-aminohippurate clearance) and glomerular filtration rate (Cr-EDTA clearance) RA was calculated according to the model originally established by Gomez. Following baseline measurements, the participants (n = 110, mean age 30 years) were randomly allocated to 12 months of treatment with either candesartan or placebo followed by repetition of measurements and withdrawal of medication. Four-hour ambulatory BP (ABP) was recorded at baseline, by end of active treatment and after 6 months, 1, 2, 3, 5, and 10 years. ABP was analyzed according to RA achieved at the end of active treatment. Candesartan reduced RA by 14% (P < 0.01). Ten years posttreatment systolic ABP increased by 2.1 mmHg (P = 0.04) and diastolic by 4.2 mmHg (P < 0.01) compared with baseline, without any difference between treatment arms. A high posttreatment RA was associated with higher BP levels during follow-up, but long-term alterations in 24-h BP were similar in participants with low and high RA and not different between treatment arms. RA is associated with 24-h BP levels, but temporary lowering of BP and RA by candesartan does not prevent BP from increasing further. Prevention of hypertension appears not feasible by short-term inhibition of the rennin-angiotensin system in young adults.

Increased angiotensinogen expression, urinary angiotensinogen excretion, and tissue injury in nonclipped kidneys of two-kidney, one-clip hypertensive rats.

In angiotensin II (ANG II)-dependent hypertension, there is an angiotensin type 1 receptor-dependent amplification mechanism enhancing intrarenal angiotensinogen (AGT) formation and secretion in the tubular fluid. To evaluate the role of increased arterial pressure, AGT mRNA, protein expression, and urinary AGT (uAGT) excretion and tissue injury were assessed in both kidneys of two-kidney, one-clip Sprague-Dawley hypertensive rats subjected to left renal arterial clipping (0.25-mm gap). By 18-21 days, systolic arterial pressure increased to 180 ± 3 mmHg, and uAGT increased. Water intake, body weights, 24-h urine volumes, and sodium excretion were similar. In separate measurements of renal function in anesthetized rats, renal plasma flow and glomerular filtration rate were similar in clipped and nonclipped kidneys and not different from those in sham rats, indicating that the perfusion pressure to the clipped kidneys remained within the autoregulatory range. The nonclipped kidneys exhibited increased urine flow and sodium excretion. The uAGT excretion was significantly greater in nonclipped kidneys compared with clipped and sham kidneys. AGT mRNA was 2.15-fold greater in the nonclipped kidneys compared with sham (1.0 ± 0.1) or clipped (0.98 ± 0.15) kidneys. AGT protein levels were also greater in the nonclipped kidneys. The nonclipped kidneys exhibited greater glomerular expansion and immune cell infiltration, medullary fibrosis, and cellular proliferation than the clipped kidneys. Because both kidneys have elevated ANG II levels, the greater tissue injury in the nonclipped kidneys indicates that an increased arterial pressure synergizes with increased intrarenal ANG II to stimulate AGT production and exert greater renal injury.

Influence of oxygen plasma treatment parameters on the properties of carbon fiber

This study is focused on the impact of oxygen plasma treatment on properties of carbon fibers and interfacial adhesion behavior between the carbon fibers and epoxy resin. The influences of the main parameters of plasma treatment process, including duration, power, and flow rate of oxygen gas were studied in detail using interlaminar shear strength (ILSS) of carbon fiber composites. The ILSS of composites made of carbon fibers treated by oxygen plasma for 1 min, at power of 125 W, and oxygen flow rate of 100 sccm presented a maximum increase of 28% compared to composites made of untreated carbon fibers. Furthermore, carbon fibers were characterized by scanning electron microscopy (SEM), tensile strength test, attenuated total reflectance Fourier transform infrared (ATR-FTIR), and Raman spectroscopy analyses. It was found that the concentration of reactive functional groups on the fiber surface was increased after the plasma modification, as well the surface roughness, which finally improved the interfacial adhesion between carbon fibers and epoxy resin. However, high power and long exposure times could partly damage the surface of carbon fibers and decrease the tensile strength of filaments and ILSS of treated fiber composites.

CVVHD treatment with CARPEDIEM: small solute clearance at different blood and dialysate flows with three different surface area filter configurations.

The CARdiorenal PEDIatric EMergency (CARPEDIEM) machine was originally designed to perform only continuous venovenous hemofiltration (CVVH) in neonatal and pediatric patients. In some cases, adequate convective clearance may not be reached because of a limited blood flow. In such conditions, the application of diffusive clearance [continuous venovenous hemodialysis (CVVHD)] would help optimize blood purification. In this study, the CARPEDIEM™ machine was modified to enable the circulation of dialysis through the filter allowing testing of the performance of CARPEDIEM™ machine in CVVHD. Three different polyethersulfone hemodialyzers (surface area = 0.1m(2), 0.2m(2), and 0.35m(2), respectively) were tested in vitro with a scheduled combination of plasma flow rates (Qp = 10-20-30ml/min) and dialysis fluid flow rate (Qd = 5-10-15ml/min). Three sessions were performed in co-current and one in counter-current configuration (as control) for each filter size. Clearance was measured from the blood and dialysate sides and results with mass balance error greater than 5% were discarded. Urea and creatinine clearances for each plasma/dialysate combination are reported: clearance increase progressively for every filter proportionally to plasma flow rates. Similarly, clearances increase progressively with dialysate flow rates at a given plasma flow. The clearance curve tends to present a steep increase for small increases in plasma flow in the range below 10ml/min, while the curve tends to plateau for values averaging 30ml/min. As expected, the plateau is reached earlier with the smaller filter showing the effect of membrane surface-area limitation. At every plasma flow, the effect of dialysate flow increase is evident and well defined, showing that saturation of effluent was not achieved completely in any of the experimental conditions explored. No differences (p > 0.05 for all values) were obtained in experiments using whole blood instead of plasma or using co-current versus counter-current dialysate flow configuration. Although plasma flow and filter surface give an important contribution to the level of clearance urea and creatinine, it appears evident that dialysate flow plays an essential role in the blood purification process, justifying the use of CVVHD versus CVVH in case of high dialysis dose requirement and/or limited blood flow rate.

Glucagon-like peptide-1 does not have acute effects on central or renal hemodynamics in patients with type 2 diabetes without nephropathy.

During acute administration of native glucagon-like peptide-1 (GLP-1), we previously demonstrated central hemodynamic effects in healthy males, whereas renal hemodynamics, despite renal uptake of GLP-1 in excess of glomerular filtration, was unaffected. In the present study, we studied hemodynamic effects of GLP-1 in patients with type 2 diabetes under fixed sodium intake. During a 3-h infusion of GLP-1 (1.5 pmol·kg(-1)·min(-1)) or saline, intra-arterial blood pressure and heart rate were measured continuously, concomitantly with cardiac output estimated by pulse contour analysis. Renal plasma flow, glomerular filtration rate, and uptake/release of hormones and ions were measured using Fick's Principle after catheterization of a renal vein. Urine collection was conducted throughout the experiments at voluntary voiding, and patients remained supine during the experiments. During the GLP-1 infusion, systolic and diastolic blood pressure and cardiac output remained unchanged, whereas heart rate increased significantly. Arterio-venous gradients for GLP-1 exceeded glomerular filtrations significantly, but renal plasma flow and glomerular filtration rate as well as renal sodium and lithium excretion were not affected. In conclusion, acute administration of GLP-1 in patients with type 2 diabetes leads to a positive chronotropic effect, but in contrast to healthy individuals, cardiac output does not increase in patients with type 2 diabetes. Renal hemodynamics and sodium excretion are not affected.

The correlation between effective renal plasma flow (ERPF) and glomerular filtration rate (GFR) with renal scintigraphy 99mTc-DTPA study

The prevalence of chronic renal diseases in Indonesia has an increasing annual trend, because it is frequently unrecognized and often co-exists with other disease. GFR and ERPF are parameters currently utilized to estimate renal function at routine renal scintigraphy 99m-Tc DTPA study. This study used 99m-Tc DTPA to measure GFR and ERPF. The purpose of this study was to find the correlation between ERPF and GFR, for ERPF analysis with Schlegel's method, and GFR analysis with Gate's method, as well as to find correction factor between both variables. Analysis of renal scintigraphy has been performed at Department of Nuclear Medicine Pertamina Center Hospital to thirty patient images acquired from 2014 to 2015 which were analyzed retrospectively data, using gamma camera dual head with counting method from renal scintigraphy 99m-Tc DTPA study. The calculation was executed by means of both display and manual calculation. Pearson's statistical analysis resulted on Positive Correlation for all data, with ERPF and GFR (display) showing Strongly Positive Correlation (r = 0.82; p- value < 0.05). Standard deviation was found to be 27.58 and 107.64 for GFR and ERPF (display), respectively. Our result indicated that the use of 99mTc-DTPA measure ERPF was not recommended.

Chronic Nicotine Exposure Abolishes Maternal Systemic and Renal Adaptations to Pregnancy in Rats.

Pregnancy is characterized by maternal systemic and intrarenal vasodilation, leading to increases in the renal plasma flow (RPF) and glomerular filtration rate (GFR). These responses are mainly mediated by nitric oxide (NO) and relaxin. The impact of cigarette smoking on the maternal adaptations to pregnancy is unclear. Here we evaluated the effects of chronic exposure to nicotine on systemic and intrarenal parameters in virgin (V) and 14-day pregnant (P) Wistar rats. V and P groups received saline or nicotine (6 mg·kg-1·day-1) respectively, via osmotic minipumps for 28 days, starting 14 days before pregnancy induction. Nicotine induced a 10% increase in blood pressure in the V group and minimized the characteristic pregnancy-induced hypotension. Renal sympathetic nerve activity (rSNA) and baroreflex sensitivity were impaired by nicotine mainly in the P group, indicating that the effect of nicotine on blood pressure was not mediated by nervous system stimulation. Nicotine had no effect on GFR in the V rats but reduced GFR of the P group by 30%. Renal expression of sodium and water transporters was downregulated by nicotine, resulting in increased fractional sodium excretion mainly in the P group, suggesting that nicotine compromised the sodium and water retention required for normal gestation. There was a reduction in the expression of inducible NO synthase (iNOS) in both the kidney tissue and renal artery, as well as in the expression of the relaxin receptor (LGR7). These results clearly show that nicotine induced deleterious effects in both virgin and pregnant animals, and abolished the maternal capacity to adapt to pregnancy.

Deposition, nanostructure and phase composition of suspension plasma-sprayed hydroxyapatite coatings

Nanostructured hydroxyapatite (HA) coatings were successfully deposited on stainless steel substrates by suspension plasma spray (SPS) method. The suspension was prepared by a wet chemical method using Ca(NO3)2 and (NH4)2HPO4 as source materials. The TEM morphologies show that these HA particles are needle-like nanowires. The effect of hydrogen flow rate of plasma forming gas on the coating properties has been intensively studied. FE-SEM images confirm that coatings are nanostructured. X-ray diffraction pattern shows that as-sprayed coatings are HA phases and the crystal size is estimated to be less than twenty nanometers when low hydrogen flow rate is used. When high hydrogen flow rate is utilized, secondary phases appear in the as-sprayed HA coatings and the crystal size increases to dozens of nanometers. Fourier transform infrared spectroscopy and MicroRaman spectroscopy indicate the significant presence of OH− and CO32- ions in the coatings.

Diagnostics of Hybrid Water/Argon Thermal Plasma Jet with Water, Ethanol and Their Mixture Injection to Plasma

A plasma torch with the water/argon stabilization of an arc is characterized by extremely hot and high velocity plasma together with the relatively low flow rate of plasma, therefore, the torch might be properly used for plasma suspension spraying. Enthalpy probe and emission spectroscopy measurements were carried out at constant arc power with the combination of the injection of water, ethanol or their mixture to the plasma jet to diagnose the changes in temperature, heat flux and other characteristics.

Optimizing Humic Acid Removal by Modifying the Surface Chemistry of Plasma Polymerized Allylamine Coated Particles

Plasma polymerized allylamine films were deposited onto quartz particles at low pressure to optimize humic acid removal by varying the plasma power, flow rate, and polymerization times. Increasing the plasma power increased the number of positively charged groups and humic acid removal. Increasing the allylamine flow rate increased the number of positively charged groups but maximum humic acid removal was observed at 6.48 sccm due to humic acid removal by positively charged and uncharged crosslinked species. Longer polymerization times increased the number of positively charged groups while similar humic acid removal resulted as the larger humic acid molecule cannot penetrate as readily into the film as the acid orange 7 used to determine the number of positively charged groups. Manipulation of the plasma parameters has shown to provide significant control over humic acid removal.

Synthesis of Silicon Nanoparticles and Nanowires by a Nontransferred Arc Plasma System

Silicon nanomaterials were synthesized from solid silicon powder in microsize using a nontransferred arc plasma system. Synthesized silicon nanomaterials were sphere or wire in morphology according to the input power of arc plasma, the flow rate of plasma forming gas, and the collecting position of product. The product was spherical nanoparticles at a high input power for complete evaporation, while it was nanowires at a relatively low input power. The mean diameter of synthesized silicon nanoparticles was increased from 20.52 nm to 40.01 nm by increasing the input power from 9 kW to 13 kW. On the other hand, the diameter of silicon nanowires was controllable by changing the flow rate of plasma forming gas. The mean diameter of silicon nanowires was increased from 16.69 nm to 23.03 nm by decreasing the plasma forming gas flow rate from 15 L/min to 12 L/min.

Sympathetic nerve to the ovary regulates ovarian testosterone secretion in female rats

Previously, we demonstrated that electrical stimulation of the superior ovarian nerve (SON), but not the ovarian nerve plexus (ONP), reduces the secretion rate of estradiol from the ovary via activation of alpha 2-adrenoceptors in rats. The inhibitory effect of SON on estradiol secretion may be due to reduced production of testosterone, a direct precursor of estradiol. Here, we examined the effects of electrical stimulation of the SON and the ONP on ovarian testosterone secretion in rats. On the day of estrous, ovarian venous blood was collected intermittently from the ovarian vein. The secretion rate of testosterone from the ovary was calculated from the difference in the testosterone concentration between ovarian venous plasma and systemic arterial blood plasma, and the rate of ovarian venous plasma flow. Stimulation of either the SON or ONP reduced the secretion rate of testosterone from the ovary. The reduction of the testosterone secretion rate by SON stimulation was not influenced by an alpha 2-adrenoceptor antagonist (yohimbine), but it was abolished by an alpha 1-adrenoceptor antagonist (prazosin). Our results show that ovarian nerves have an inhibitory role in ovarian testosterone secretion, via activation of alpha 1-adrenoceptors, but not alpha 2- adrenoceptors. This, therefore, indicates that the reduction of estradiol secretion by SON stimulation is independent of the reduction of testosterone secretion.

Optimum Conditions for the Efficacy and Safety of Cryofiltration Apheresis: An Analysis of Circuit Temperatures Depending on Plasma Flow Rate and Cooling Coil Lengths/Turns.

A system providing both appropriate cooling and warming are needed for the efficacy and safety of cryofiltration (CF) plasmapheresis. We measured some points of CF circuit temperatures with varying plasma flow rates (QP = 10-40 mL/min) and the numbers of connecting cooling coils (one or two) under the conditions of blood flow rate (QB ) 100 mL/min with 7700-mm coil length, 19 turns, and 50-mL priming volume. We measured the respective temperatures of each point of starting/returning for an extracorporeal circuit (TA /TV ), intracooling coil (TC ), and post-plasma fractionator (PF) (TPF ). The subtraction of TV from TA (ΔT) was used as an indicator of safe return. There were no significant differences in TC , TPF , or ΔT in accordance with each QP between that of one and two coils. All of the Tc values under the condition QP ≤ 20 mL/min achieved <4°C. The TPF under the condition QP ≥ 20 mL/min was not significantly different compared to that of QP 30 mL/min (the lowest condition). Although the ΔT increased depending on the QP increase, the ΔT under the condition QP ≤ 15 mL/min was not significantly different from that of the control (one-way double-filtration plasmapheresis [DFPP]) group. We conclude that (i) one coil is enough for effective cooling in CF, and (ii) an ideal QP that fulfills the required conditions for both effective cooling and sufficient warming of returning fluid does not exist, but QP from 15 to 20 mL/min may be a relevant range.

Long-term changes in renal function and perfusion in heart failure patients with reduced ejection fraction.

IntroductionLittle is known about the natural course of renal function and renal hemodynamics in heart failure patients with reduced ejection fraction (HFREF).Methods and resultsWe prospectively studied effective renal plasma flow (ERPF) and glomerular filtration rate (GFR) in 73 HFREF patients with 125I-iothalamate/131I-hippuran clearances with a mean follow-up of 34.6 ± 4.4 months. Fifteen percent were female, with age 58 ± 12 years and left ventricular ejection fraction (LVEF) 29 ± 10 %. Baseline GFR was 81 ± 23 mL/min/1.73 m2 and declined 0.6 ± 4.7 mL/min/1.73 m2 per year. Baseline ERPF was 292 ± 83 mL/min/1.73 m2 and declined 4.3 ± 19 mL/min/1.73 m2 per year. Of the baseline variables, older age and high urinary kidney injury molecule-1 were the only variables associated with GFR decline (p < 0.05). Following stepwise backward analysis, only age (p < 0.001) remained significant. In addition, we found an association between change in GFR and changes in ERPF, N-terminal pro-brain natriuretic peptide and renovascular resistance. In the multivariable analysis, only the change in ERPF remained significantly associated with a change in GFR (p < 0.001).ConclusionIn this cohort of stable chronic HFREF patients, the average decline in GFR over time was small. The decline of GFR was associated with a higher age and a lower baseline GFR, and was strongly related to changes in renal perfusion.Electronic supplementary materialThe online version of this article (doi:10.1007/s00392-015-0881-9) contains supplementary material, which is available to authorized users.

Effects of Pulsatile Flow and Backwashing on Plasma Flow Rate in an Implantable Plasmapheresis. I. Theory and Principle

The first stage of blood filtration in kidneys involves separation of solids (blood cells and proteins) from liquid blood part (plasma). In an attempt to design and fabricate an implantable artificial kidney, this stage is considered fundamental and as such is given both in depth theoretical and experimental consideration. This report outlines the theory of backwashing to determine permeate flux dependence on time during cross-flow filtration in the case of blood cell separation. The presented method reduces, and we hope for elimination of, filter membrane fouling. The method proposed in this research will use the internal energy of the body (blood pressure pulsation) to provide enough movement for a diaphragm pump to provide a backwash flow as a phase of the filtration cycle. We investigated the effect of operational parameters such as cross-flow velocity, Womersley number, pressure difference, and filtration time on permeate flow rate.

Correlation of serum uric acid and serum creatinine in hypothyroidism

Background: Hypothyroidism is a progressive disorder that presents with diverse degrees of thyroid failure and metabolic consequences. Purine metabolism can be affected by disturbance in thyroid hormones, which leads to alteration in the uric acid levels, leading to hyperuricemia and subsequently causing gout. Also, hemodynamic changes occur in hypothyroidism that leads to reduction in renal plasma flow and glomerular filtration rate, which also causes increase in the levels of serum uric acid and serum creatinine. Aims and Objective: To determine whether thyroid dysfunction, subclinical and overt, has deleterious effects on renal function. Materials and Methods: This was a cross-sectional study that comprised 108 individuals (56 cases and 52 controls; 52 men and 56 women) aged between 20 and 60 years. Case group comprised suspected cases of hypothyroidism. Serum TSH, T4, T3, uric acid, and creatinine were estimated after applying inclusion and exclusion criteria. Result: Uric acid and creatinine levels were significantly elevated in case group as compared to control group (7.09 ± 0.45 and 1.52± 0.16 mg/dL versus 4.08 ± 0.25 and 0.62 ± 0.05 mg/dL, respectively; p < 0.001). There was insignificant correlation between serum uric acid and creatinine levels with hypothyroidism (r = 0.185, p = 0.172 and r = 0.082, p = 0.550). Also, there was no significant correlation between serum uric acid and creatinine levels with the age in hypothyroidism (r = 0.143; p = 0.292 and r = -20.154; p = 0.257, respectively). Conclusion: Hypothyroidism causes significant increase in serum uric acid and creatinine levels. Therefore, we would emphasize the importance of the routine evaluation of serum uric acid and creatinine levels in patients with hypothyroidism.

Non-contact acoustic capture of microparticles from small plasma volumes.

Microparticles (MP) are small (100-1000 nm) membrane vesicles shed by cells as a response to activation, stress or apoptosis. Platelet-derived MP (PMP) has been shown to reflect the pathophysiological processes of a range of cardiovascular diseases and there is a potential clinical value in using PMPs as biomarkers, as well as a need to better understand the biology of these vesicles. The current method for isolating MP depends on differential centrifugation steps, which require relatively large sample volumes and have been shown to compromise the integrity and composition of the MP population. We present a novel method for rapid, non-contact capture of PMP in minute sample volumes based on a microscale acoustic standing wave technology. Capture of PMPs from plasma is shown by scanning electron microscopy and flow cytometry. Furthermore, the system is characterized with regards to plasma sample concentration and flow rate. Finally, the technique is compared to a standard differential centrifugation protocol using samples from both healthy controls and ST-elevation myocardial infarction (STEMI) patient samples. The acoustic system is shown to offer a quick and automated setup for extracting microparticles from small sample volumes with higher recovery than a standard differential centrifugation protocol.

Specific adsorbents for myasthenia gravis autoantibodies using mutants of the muscle nicotinic acetylcholine receptor extracellular domains.

Myasthenia gravis (MG) is usually caused by antibodies against the muscle acetylcholine receptor (AChR). Plasmapheresis and immunoadsorption are often used to treat non-responsive patients. Antigen-specific immunoadsorption would remove only the pathogenic autoantibodies reducing side-effects. We expressed AChR extracellular domain mutants for use as specific adsorbents, and characterized them. Antigenicity and capacity for autoantibody binding were improved compared to the wild-type proteins. Adsorption appeared to be fast, as high plasma flow-rates could be applied. The bound autoantibodies were eluted repeatedly, allowing column reuse, without compromise in efficiency. Overall, the adsorbents were specific, efficient and suitable for use in therapy.