Improved dialysis removal of protein-bound uremic toxins by salvianolic acids

Li, Jianping; Wang, Yingyi; Xu, Xuejun; Cao, Wenjuan; Shen, Zhiqiang; Wang, Nan; Leng, Jing; Zou, Ning; Shang, Erxin; Zhu, Zhenhua; Guo, Jianming; Duan, Jin‐Ao

doi:10.1016/j.phymed.2018.12.018

Cited by 33 publications

(32 citation statements)

References 25 publications

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“…Analysis of the components in the Dan-Hong injection and their pharmacodynamic effects has revealed that DSS, SAA, SAB, and HSYA are the main active ingredients [30,46,[49][50][51]. Therefore, a pharmacokinetic study of the these four active ingredients appeared to be reasonable and necessary.…”

Section: Discussionmentioning

confidence: 99%

Pharmacokinetics of Active Ingredients of Salvia miltiorrhiza and Carthamus tinctorius in Compatibility in Normal and Cerebral Ischemia Rats: A Comparative Study

Ying

et al. 2019

Eur J Drug Metab Pharmacokinet

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Background and Objective Dan-Hong injection, which comprises extracts of Salvia miltiorrhiza and Carthamus tinctorius, promotes blood circulation and reduces blood stasis. Combination of S. miltiorrhiza and C. tinctorius is more effective in treating cerebral ischemia than S. miltiorrhiza alone. This study aimed to examine the pharmacokinetic characteristics of four active ingredients of S. miltiorrhiza and C. tinctorius, namely danshensu (DSS), hydroxysafflor yellow A (HSYA), and salvianolic acid A (SAA) and B (SAB) in normal and cerebral ischemia rats. Methods Normal and cerebral ischemia rats were injected via the tail vein with each active ingredient, and blood was collected through the jaw vein at different time points. The plasma concentration of the compatibility group was analyzed by high-performance liquid chromatography, and pharmacokinetic parameters were determined using Pharmacokinetic Kinetica 4.4 software. Results The pharmacokinetics of the four active ingredients in the normal and cerebral ischemia rats were consistent with a two-compartment model. The area under the concentration-time curve was higher in normal rats than in cerebral ischemia rats, with a highly significant difference for SAA (P < 0.01). Clearance rates were lower in normal rats than in cerebral ischemia rats, with DSS showing the most significant difference (P < 0.01). Furthermore, there were significant differences between normal and cerebral ischemia rats in the distribution phase-elimination half life for DSS, SAA, and HSYA, as well as in the apparent volume of distribution for the central compartment for DSS and HSYA (P < 0.01). The plasma concentrations of the four active ingredients were higher in normal rats than in cerebral ischemia rats. Conclusion Cerebral ischemia rats showed higher drug clearance rates and longer retention times than normal rats, which may be due to destruction of the blood-brain barrier during cerebral ischemia-reperfusion. The four active ingredients likely integrated and interacted with each other to affect target sites in the brain to protect against cerebral ischemic injury.

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Section: Discussionmentioning

confidence: 99%

Pharmacokinetics of Active Ingredients of Salvia miltiorrhiza and Carthamus tinctorius in Compatibility in Normal and Cerebral Ischemia Rats: A Comparative Study

Ying

et al. 2019

Eur J Drug Metab Pharmacokinet

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“…First, to achieve higher S-Alb levels, higher protein diets are often required; which result in excessive metabolites (such as P, BUN and so on) that cannot be completely eliminated. The second, because of the Gibbs-Donnan effect, protein-bound uremic toxins are difficult to remove during hemodialysis [11][12][13][14].…”

Section: Discussionmentioning

confidence: 99%

In maintenance hemodialysis patients, there were “U-shaped” relationships between serum albumin level and mortality or hospitalization, negative linear relationship between serum albumin level and hospitalization for infection.

Jia

Chen

Wang³

et al. 2019

Preprint

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Background: Few studies are available on the non-linear association between serum albumin (S-Alb) level and prognosis in maintenance hemodialysis (MHD) patients. Methods: All stable MHD patients treated in our center from 2007 to 2011 were enrolled into this study. Demographics, laboratory data, hospitalization and mortality were collected; Cox regressive models were fitted to investigate predicting outcomes, restricted cubic splines (RCS) were allowing for non-linear association between S-Alb and prognosis. Results: S-Alb was independent protective factor for mortality, all-cause hospitalization, hospitalization for cardiovascular or cerebrovascular disease and hospitalization for infection. The relationships between S-Alb and mortality, all-cause hospitalization, hospitalization for cardiovascular or cerebrovascular disease were U-shaped; relationships between S-Alb and hospitalization for infection were negative linear relationships both in univariable Cox regression models and in multivariable Cox regression. Conclusions: In MHD population, there were “U-shaped” relationships between serum albumin level and mortality or hospitalization; the potential risks associated with excessive S-Alb should been taken into consideration. There was negative linear relationship between S-Alb and hospitalization for infection, S-Alb may be even more important in preventing infection in MHD population.

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“…Alternative agents have been considered but not yet shown to satisfy this requirement. 34 Imposing physical-chemical changes could also increase the free fractions of bound solutes as blood passes through the dialyzer. The free fraction of many bound solutes can be increased by lowering the blood pH.…”

Section: Protein-bound Solutesmentioning

confidence: 99%

Improving Clearance for Renal Replacement Therapy

2021

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The adequacy of hemodialysis is now assessed by measuring the removal of the single solute urea. The urea clearance provided by current dialysis methods is a large fraction of the blood flow through the dialyzer, and therefore cannot be increased much further. Other solutes which are less effectively cleared than urea may however contribute more to the residual uremic illness suffered by hemodialysis patients. We here review a variety of methods which could be employed to increase the clearance of such non-urea solutes. New clinical studies will be required to test the extent to which increasing solute clearances improves patients' health.

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Improved dialysis removal of protein-bound uremic toxins by salvianolic acids

Cited by 33 publications

References 25 publications

Pharmacokinetics of Active Ingredients of Salvia miltiorrhiza and Carthamus tinctorius in Compatibility in Normal and Cerebral Ischemia Rats: A Comparative Study

Pharmacokinetics of Active Ingredients of Salvia miltiorrhiza and Carthamus tinctorius in Compatibility in Normal and Cerebral Ischemia Rats: A Comparative Study

In maintenance hemodialysis patients, there were “U-shaped” relationships between serum albumin level and mortality or hospitalization, negative linear relationship between serum albumin level and hospitalization for infection.

Improving Clearance for Renal Replacement Therapy

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