Combination of Maintenance Hemodialysis with Hemoperfusion: A Safe and Effective Model of Artificial Kidney

Chen, Shunjie; Jiang, Gengru; Shan, Jian-Ping; Lü, Wei; Huang, Haidong; Ji, Gang; Wu, Ping; Wu, Gu-Feng; Wang, Wei; Zhu, Chun; Fan, Biao

doi:10.5301/ijao.2011.7748

Cited by 49 publications

(74 citation statements)

References 16 publications

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“…Clinically, it has been reported that by using HA130 cartridge for patients with end-stage renal disease, there was a better removal of middle uremic toxins compared to the membrane modality, and HP benefits the life quality [32] and nutritional status [41] of long-term dialysis patients. HA230 cartridge has been used for intoxication [42], and might also be used for cancer patients after chemotherapy for the removal of excessive cytostatics in the blood.…”

Section: Discussionmentioning

confidence: 99%

Biocompatibility and Cytotoxic Evaluation of New Sorbent Cartridges for Blood Hemoperfusion

et al. 2018

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Background/Aims: The use of adsorption cartridges for hemoperfusion (HP) is rapidly evolving. For these devices, the potential induced cytotoxicity is an important issue. The aim of this study was to investigate potential in vitro cytotoxic effects of different sorbent cartridges, HA130, HA230, HA330, HA380 (Jafron, China), on U937 monocytes. Methods: Monocytes were exposed to the sorbent material in static and dynamic manners. In static test, cell medium samples were collected after 24 h of incubation in the cartridges. In dynamic test, HP modality has been carried out and samples at 30, 60, 90, and 120 min were collected. Results: Compared to control samples, there was no evidence of increased necrosis or apoptosis in monocytes exposed to the cartridges both in the static and dynamic tests. Conclusion: Our in vitro testing suggests that HA cartridges carry an optimal level of biocompatibility and their use in HP is not associated with adverse reactions or signs of cytotoxicity.

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Section: Discussionmentioning

confidence: 99%

Biocompatibility and Cytotoxic Evaluation of New Sorbent Cartridges for Blood Hemoperfusion

et al. 2018

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“…a late HP conducted HDHP (LHDHP). As the insertion of a HP apparatus into the dialysis circuit during the late course of HD may provoke the status of hypovolemia, EHDHP has been the most widely used mode in most of the dialysis centers, 15,16 to avoid the ultrafiltration-related interdialysis events, such as interdialysis hypotension (IHD).…”

Section: Introductionmentioning

confidence: 99%

“…11 An alternative approach, comprising of sequential hemodialysis and hemoperfusion (HDHP), has been used for about 50 years and proved to be excel over HD in regular elimination of middle-sized molecules and cytokines. [12][13][14][15] In clinical use, HDHP is usually conducted by adding a commercially available hemoperfusion (HP) apparatus into the dialysis circuit in series with a standard hemodialyzer. The HP apparatus generally contains 80-300 g of activated charcoal-coated particles effective for continuous use of approximate two hours.…”

Section: Introductionmentioning

confidence: 99%

The optimal timing of hemoperfusion component in combined hemodialysis–hemoperfusion treatment for uremic toxins removal

et al. 2014

Renal Failure

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The combination of hemodialysis-hemoperfusion (HDHP) has been proved to be superior to hemodialysis (HD) in eliminating uremic toxins. There are two methods of combination of HD and HP: the HP regime is utilized during the first two-hour an early HP conducted HDHP (EHDHP) or the last two-hour late HP conducted HDHP (LHDHP) of 4 h regular HD session. The present study was to compare these two methods in uremic toxins removal. Twenty adult chronic HD patients were enrolled in this self-control method study. The patients were randomized to receive one session of EHDHP or LHDHP. Two weeks later, the dialysis modalities were switched. The reduction ratio (RR) of targeted uremic toxins for each session was assessed. Both EHDHP and LHDHP showed a significant removal of small water-soluble solutes, middle-sized toxins and cytokines as well (p50.05). There were no significant differences between two methods in RR of small water-soluble solutes, like urea and creatinine. For middle-sized molecules and cytokines, such as PTH, b 2 -M, IL-1, IL-6, and TNF-a, the RR was markedly increased in LHDHP than that in EHDHP (p50.05). LHDHP showed no more intradialytic events than EHDHP. The combination of HD and HP in the last two hours in one hemodialysis session had more effect on eliminating middle-sized toxins and cytokines.

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“…5 ), which is consistent with other studies [20] . It has also reported that the combined HD + HP treatment can effectively reduce the serum levels of leptin, hsCRP, β2-MG, IL-6, iPTH and TNF-α [21,22] . However, our study found that the combined HD + HP treatment did not alter the levels of hsCRP and IL-6, although the serum level of TNF-α is significantly low.…”

Section: Discussionmentioning

confidence: 99%

Effect of the Combination of Hemodialysis and Hemoperfusion on Clearing Advanced Glycation End Products: A Prospective, Randomized, Two-Stage Crossover Trial in Patients Under Maintenance Hemodialysis

et al. 2015

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Advanced glycation end products (AGEs) are protein-bound uremic toxins and are elevated in patients with the end-stage of renal disease. The present study sought to develop an effective method to remove the circulating AGEs from patients using the combination of hemodialysis (HD) and hemoperfusion (HP). Thirty-six patients undergoing maintenance HD for 3 months were randomly divided into two groups. Patients in Group 1 received HD, followed by the combined HP + HD treatment once, whereas patients in Group 2 were first treated with HP + HD and then they received the HD treatment alone. Patients treated with HD alone did not alter higher levels of serum AGEs. In contrast, patients treated with the combined HP + HD exhibited significantly lower levels of serum AGEs and TNF-α. Results from this study demonstrate that the combination of HD + HP treatment may be an effective and better approach to remove the protein-bound uremic toxins and inflammatory cytokines.

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Combination of Maintenance Hemodialysis with Hemoperfusion: A Safe and Effective Model of Artificial Kidney

Abstract: HD+HP was superior to HD in regularly eliminating middle and large molecule uremic toxins accumulated in the body. These findings suggest a potential role for HD+HP in the treatment to improve the quality of life and survival rate of MHD patients.

Cited by 49 publications

References 16 publications

Biocompatibility and Cytotoxic Evaluation of New Sorbent Cartridges for Blood Hemoperfusion

Biocompatibility and Cytotoxic Evaluation of New Sorbent Cartridges for Blood Hemoperfusion

The optimal timing of hemoperfusion component in combined hemodialysis–hemoperfusion treatment for uremic toxins removal

Effect of the Combination of Hemodialysis and Hemoperfusion on Clearing Advanced Glycation End Products: A Prospective, Randomized, Two-Stage Crossover Trial in Patients Under Maintenance Hemodialysis

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