Patterns of Proteins Removed with High-Flux Membranes on High-Volume Hemodiafiltration Detected with a MultiDimensional LC-MS/MS Strategy

Pedrini, Luciano A.; Gmerek, Andreas; Wolters, Dirk

doi:10.1159/000365745

Cited by 14 publications

(15 citation statements)

References 26 publications

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“…HDF enhances their convective removal and is superior to HD in eliminating several small and larger uremic toxins [49, 50]. Of note, a complex pattern of >250 proteins is removed by HDF [51]. It is conceivable that some of these toxins may interact with the RBC glycocalyx and that their inferior removal may affect ESS.…”

Section: Discussionmentioning

confidence: 99%

Erythrocyte Sodium Sensitivity and Eryptosis in Chronic Hemodialysis Patients

Meyring-Wösten

Kuntsevich

Campos

et al. 2017

Kidney Blood Press Res

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Background/Aims: In hemodialysis (HD) patients the endothelial and erythrocyte glycocalyx is impaired which in turn correlates with elevated erythrocyte sodium sensitivity (ESS). Additionally, apoptotic erythrocyte death (eryptosis), characterized by phosphatidylserine (PS) exposure on the cell surface, is increased in this population. We aimed to explore the relationship of ESS and eryptosis. Methods: Blood samples were collected from 11 healthy controls and 20 chronic HD patients before and after midweek HD. ESS was quantified by the salt blood test. PS-exposure, intracellular reactive oxygen species (ROS) of erythrocytes and reticulocytes were assessed by flow cytometry. Results: Compared to controls ESS was significantly higher in HD patients preHD and did not change during treatment. The percentage of eryptotic cells did not differ between controls and patients preHD. However, eryptosis decreased during HD. ESS and eryptosis were uncorrelated, while eryptosis was positively correlated with intracellular ROS and percent reticulocytes. Conclusions: Higher ESS levels in HD patients indicate a pathologic glycocalyx. ESS and eryptosis were not correlated. The decreased eryptosis postHD may possibly be related to dialytic uremic toxin removal, but is likely multifactorial. The relationship between eryptosis and intracellular ROS warrants further research.

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Section: Discussionmentioning

confidence: 99%

Erythrocyte Sodium Sensitivity and Eryptosis in Chronic Hemodialysis Patients

Meyring-Wösten

Kuntsevich

Campos

et al. 2017

Kidney Blood Press Res

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“…Pedrini et al [ 63 ] employed Multidimensional Protein identification Technology to characterize in a prospective crossover study the removal of middle-molecular weight solutes during high-volume post-dilution hemodiafiltration (a mixed diffusive/convective dialytic technique) with two high-flux dialyzer membranes (Amembris and Polyamix). A total of 277 proteins were identified by the proteomic approach in the dialysate fluids, removal capability being higher with the Amembris membrane (B. Braun Avitum, Melsungen, Germany).…”

Section: Proteomic and Extracorporeal Blood Purificationmentioning

confidence: 99%

“…A total of 277 proteins were identified by the proteomic approach in the dialysate fluids, removal capability being higher with the Amembris membrane (B. Braun Avitum, Melsungen, Germany). This is another effort to steer research toward a better knowledge of uremic toxins and the balance between intended and unintended removal of undesired and beneficial proteins [ 63 ]. In a proteomic investigation on extracorporeal blood purification techniques, Monari et al [ 64 ] showed that HFR (HemoFiltration with endogenous on-line Reinfusion), an integrated dialysis technique that combines convection, diffusion, and adsorption, is better than standard HD at removing uremic toxins, especially medium-high MW molecules.…”

Section: Proteomic and Extracorporeal Blood Purificationmentioning

confidence: 99%

Proteomic Investigations into Hemodialysis Therapy

Bonomini

Sirolli

Pieroni

et al. 2015

IJMS

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The retention of a number of solutes that may cause adverse biochemical/biological effects, called uremic toxins, characterizes uremic syndrome. Uremia therapy is based on renal replacement therapy, hemodialysis being the most commonly used modality. The membrane contained in the hemodialyzer represents the ultimate determinant of the success and quality of hemodialysis therapy. Membrane’s performance can be evaluated in terms of removal efficiency for unwanted solutes and excess fluid, and minimization of negative interactions between the membrane material and blood components that define the membrane’s bio(in)compatibility. Given the high concentration of plasma proteins and the complexity of structural functional relationships of this class of molecules, the performance of a membrane is highly influenced by its interaction with the plasma protein repertoire. Proteomic investigations have been increasingly applied to describe the protein uremic milieu, to compare the blood purification efficiency of different dialyzer membranes or different extracorporeal techniques, and to evaluate the adsorption of plasma proteins onto hemodialysis membranes. In this article, we aim to highlight investigations in the hemodialysis setting making use of recent developments in proteomic technologies. Examples are presented of why proteomics may be helpful to nephrology and may possibly affect future directions in renal research.

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“…An important effort to identify and characterize uremic toxins, and to steer research toward a better knowledge of the balance between intended and unintended removal of undesired and beneficial proteins, was carried out by Pedrini et al using the multidimensional protein identification technology (MudPIT). 24 Two high-flux membranes (Amembris and Polyamix, a polyamide membrane) were used and compared in a randomized cross-over study carried out in 16 patients being dialyzed with high-volume post-dilution HDF. Both membranes displayed high efficiency in removing solutes of different MW in spent dialysate, with Amembris membrane showing higher capability.…”

Section: Introductionmentioning

confidence: 99%

“…Though the protein removal pattern was similar, the total and protein-specific peptide spectral count of most proteins was higher when using Amembris membrane. 24 The most abundant proteins identified by MudPIT technology in dialysate included not only the compounds of which the metabolic role and effects of accumulation in the uremic plasma are known, 1 such as complement factor D, β2-microglobulin, retinol-binding protein 4, and myoglobin, but also proteins with effects which are less fully described, such as alpha-1 microglobulin/bikunin precursor and prostaglandin D2 synthase. However, vital compounds such as vitamin D-binding protein were also detected in both datasets from the membranes investigated; such depletion may lead to lack of vitamin D, an unwanted condition in HD patients 25 that may have a negative impact on survival.…”

Section: Introductionmentioning

confidence: 99%

Examining hemodialyzer membrane performance using proteomic technologies

Bonomini¹,

Pieroni²,

Liberato³

et al. 2017

TCRM

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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.

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Patterns of Proteins Removed with High-Flux Membranes on High-Volume Hemodiafiltration Detected with a MultiDimensional LC-MS/MS Strategy

Cited by 14 publications

References 26 publications

Erythrocyte Sodium Sensitivity and Eryptosis in Chronic Hemodialysis Patients

Erythrocyte Sodium Sensitivity and Eryptosis in Chronic Hemodialysis Patients

Proteomic Investigations into Hemodialysis Therapy

Examining hemodialyzer membrane performance using proteomic technologies

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