Examining hemodialyzer membrane performance using proteomic technologies

Abstract

The success and the quality of hemodialysis therapy are mainly related to both clearance and biocompatibility properties of the artificial membrane packed in the hemodialyzer. Performance of a membrane is strongly influenced by its interaction with the plasma protein repertoire during the extracorporeal procedure. Recognition that a number of medium–high molecular weight solutes, including proteins and protein-bound molecules, are potentially toxic has prompted the development of more permeable membranes. Such membrane engineering, however, may cause loss of vital proteins, with membrane removal being nonspecific. In addition, plasma proteins can be adsorbed onto the membrane surface upon blood contact during dialysis. Adsorption can contribute to the removal of toxic compounds and governs the biocompatibility of a membrane, since surface-adsorbed proteins may trigger a variety of biologic blood pathways with pathophysiologic consequences. Over the last years, use of proteomic approaches has allowed polypeptide spectrum involved in the process of hemodialysis, a key issue previously hampered by lack of suitable technology, to be assessed in an unbiased manner and in its full complexity. Proteomics has been successfully applied to identify and quantify proteins in complex mixtures such as dialysis outflow fluid and fluid desorbed from dialysis membrane containing adsorbed proteins. The identified proteins can also be characterized by their involvement in metabolic and signaling pathways, molecular networks, and biologic processes through application of bioinformatics tools. Proteomics may thus provide an actual functional definition as to the effect of a membrane material on plasma proteins during hemodialysis. Here, we review the results of proteomic studies on the performance of hemodialysis membranes, as evaluated in terms of solute removal efficiency and blood–membrane interactions. The evidence collected indicates that the information provided by proteomic investigations yields improved molecular and functional knowledge and may lead to the development of more efficient membranes for the potential benefit of the patient.

Current approaches to middle molecule removal: room for innovation

“…Recently proteomic studies of adsorptive proteins have clarified that adsorbed protein profiles differ depending on the membrane materials used [ 49 , 50 ]. For instance, the profiles of adsorbed proteins were different between cellulose triacetate (CTA) and PS, as albumin and apo-lipoprotein were mainly found in CTA, but fibrinogen and other proteins due to the coagulation cascade and platelet activation were mainly found in PS.…”

Design of Mobile Hemodialysis Apparatus for Acute Renal Failure Patient's Self-Help and Treatment Adherence

“…Mario bonomini et. al., have reviewed about the examining the advancement in the hemodialysis which have overcome certain drawbacks [4]. The extra corporeal blood purification therapy in the artificial membrane effectively works for the clearance process.…”

Assessment of removal and adsorption enhancement of high-flux hemodialyzers in convective therapies by a novel in vitro uremic matrix

“…Hemodialysis is a renal replacement therapy 1 which exploits the properties of a semipermeable membrane (or hemodialyzer) to maintain patient over-hydration, assess electrolyte balance and attain tolerable levels of uremic surrogates 2 through diffusive (high-flux hemodialysis, HD) or convective enhanced (hemodiafiltration, HDF) blood cleaning processes. Moreover, the interaction of blood with a particular exogenous material 3 , 4 (cellulosic or synthetic) and structure (symmetric or asymmetric), like the hemodialysis hollow fiber capillary, may lead to adsorption 5 , 6 . The precise mechanisms of adsorption in hemodialysis are not fully understood 7 but are likely related to the interaction of solutes to the inner surface and the porous frame of the membrane 8 , 9 .…”