First Clinical Experience with an Adjunctive Hemoperfusion Device Designed Specifically to Remove &amp;beta;&lt;sub&gt;2&lt;/sub&gt;-Microglobulin in Hemodialysis

Ronco, Claudio; Brendolan, Alessandra; Jf, Winchester; Golds, Ellen; Clemmer, J; Hd, Polaschegg; Te, Muller; Davankov,; Tsyurupa, M. P.; Павлова, Л. А.; Pavlov, Mikhail; G, La Greca; Nw, Levin

doi:10.1159/000060126

Cited by 28 publications

(20 citation statements)

References 7 publications

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“…In dogs with chronic renal failure, the plas- ma ß 2 -microglobulin levels were reduced in excess of 70% per session of combined hemodialysis and Betasorb hemoperfusion [4]. First clinical experience demonstrated a decrease in the plasma concentrations of ß 2 -microglobulin by 79 and 69% [10,11]. We now have characterized the adsorptive performance of this device with regard to 14 commonly used drugs.…”

Section: Discussionmentioning

confidence: 99%

In vitro Removal of Therapeutic Drugs with a Novel Adsorbent System

Reiter

Bordoni

Dall’Olio³

et al. 2002

Blood Purif

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Background/Aim: Substances in the middle molecular weight range have been shown to play a significant pathogenetic role in as diverse disorders as end-stage renal disease and multiple organ failure. To overcome the limitations in the amount removed by hemofilters, new sorbents with a high biocompatibility are actively being developed. Furthermore, biocompatible sorbents by their nonspecific adsorptive behavior could have great impact on detoxification treatment in exogenous intoxications. We performed an in vitro evaluation of a newly developed highly biocompatible sorbent cartridge (Betasorb^®), examining its adsorptive capacity concerning therapeutic drugs. Methods: Uremic blood spiked with a range of therapeutic drugs was recirculated for 2 h in an in vitro hemoperfusion circuit containing a Betasorb device for hemoperfusion. The drug concentrations before and after the passage of the cartridge were measured, and the total amount removed was calculated. Results: The sorbent showed effective removal of glycopeptide antibiotics, digoxin, theophylline, phenobarbital, phenytoin, carbamazepine, and valproic acid. Moderate removal could be demonstrated for tacrolimus and cyclosporine A; aminoglycosides were removed to a small extent only. Conclusions: Betasorb hemoperfusion shows a potent adsorptive capacity concerning therapeutic drugs (except aminoglycosides) and could be of major value in the treatment of intoxications. On the other hand, drug monitoring and possible adjustments are necessary during Betasorb hemoperfusion to maintain the therapeutic ranges of the drugs in blood.

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Section: Discussionmentioning

confidence: 99%

In vitro Removal of Therapeutic Drugs with a Novel Adsorbent System

Reiter

Bordoni

Dall’Olio³

et al. 2002

Blood Purif

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“…In normal and uremic canines the devices produce about a 30% fall in platelet and leukocyte counts, but no changes occurred ex vivo using human volunteer blood passed over the resin [19] or in vivo in man during clinical hemodialysis [20]. This confirms the bio-compatibility of the coating, and opens the way for extensive clinical testing.…”

Section: New Sorbent Design For Removal Of Middle Molecular Weight Prmentioning

confidence: 69%

Sorbent Augmented Dialysis: Minor Addition or Major Advance in Therapy?

et al. 2000

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“…Until recently, poor hemocompatibility, as evidenced by thrombocytopenia and neutropenia [32], has been the major clinical limitation of these materials. Newer resin adsorbents appear to have solved this issue with the addition of a hemocompatible coating [33].…”

Section: Sorbents: Theory and Practicementioning

confidence: 99%

“…The discovery of uremic toxins [7,8], other than urea and creatinine, has stimulated several investigations on alternatives to standard or high-flux hemodialysis, to remove these molecules. These methods include hemodiafiltration with [9] or without [10,11] dialysate regen-eration using sorbents, as well as hemoperfusion using adsorbents such as charcoal [12] and resins [13].…”

Section: Introductionmentioning

confidence: 99%

The Next Step from High-Flux Dialysis: Application of Sorbent Technology

et al. 2002

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The current foci of renal replacement therapy with dialysis are middle molecular weight toxins, consisting of small proteins, polypeptides and products of glycosylation and lipoxygenation. Conventional high-flux dialysis is not efficient at removing these molecules, explaining the increased interest in using sorbents to supplement dialysis techniques. Prototype biocompatible sorbents have been developed and investigated for middle molecule removal; these have been shown, in man, to remove β₂-microglobulin, angiogenin, leptin, cytokines and other molecules, without reducing platelets and leukocytes. Extensive clinical studies are underway to demonstrate the clinical utility and safety of adding routinely a sorbent hemoperfusion device to hemodialysis.

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First Clinical Experience with an Adjunctive Hemoperfusion Device Designed Specifically to Remove β<sub>2</sub>-Microglobulin in Hemodialysis

Cited by 28 publications

References 7 publications

In vitro Removal of Therapeutic Drugs with a Novel Adsorbent System

In vitro Removal of Therapeutic Drugs with a Novel Adsorbent System

Sorbent Augmented Dialysis: Minor Addition or Major Advance in Therapy?

The Next Step from High-Flux Dialysis: Application of Sorbent Technology

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