Review: the effect of polymethylmethacrylate dialysis membranes on uraemic pruritus

Aucella, Filippo; Vigilante, M.; Gesuete, Antonio

doi:10.1093/ndtplus/sfq031

Cited by 23 publications

(28 citation statements)

References 26 publications

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“…The use of PMMA membranes has been shown to ameliorate the severity and frequency of pruritus in HD patients [33], probably due to adsorption of a 160,000-Da molecular-weight molecule with stimulatory effect on mast cells [25]. These findings were confirmed in other studies [34,35,36]. …”

Section: Clinical Applications Of Adsorption Dialysissupporting

confidence: 57%

Adsorption Dialysis: From Physical Principles to Clinical Applications

Aucella

Gesuete

Vigilante³

et al. 2013

Blood Purif

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The uremic syndrome is characterized by the retention of various solutes that would normally be excreted by the kidneys. The substances that interact negatively with biologic functions are called uremic toxins. Over the past five decades, the membranes used for the treatment of chronic kidney disease have continuously evolved. The exposure of blood to any extracorporeal artificial surface results in the activation of several pathways within the body, including those involving coagulation and complement activation. One of the by-products of this generalized activation process is protein adsorption to the membrane surface, another phenomenon which can have a significant impact on solute removal. In fact, an array of studies showed that with increasing size of middle-sized proteins and other compounds, relatively more clearance is achieved by membrane adsorption compared with loss into the dialysate. A high adsorptive capacity, one of the main features of polymethylmethacrylate (PMMA) membranes, is very helpful and may both increase the total amount of solutes removed and remove different kinds of solutes. In this setting, a few studies have shown a variety of efficient clinical implications for adsorption hemodialysis, such as uremic pruritus, anemia, carpal tunnel syndrome and renal amyloidosis, immune dysfunction and improved response to vaccination. In addition, nutrition and survival were also improved using PMMA membranes.

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Section: Clinical Applications Of Adsorption Dialysissupporting

confidence: 57%

Adsorption Dialysis: From Physical Principles to Clinical Applications

Aucella

Gesuete

Vigilante³

et al. 2013

Blood Purif

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“…The therapeutic effect might be due to better removal of unknown high-molecular-weight uremic toxins using a highly permeably dialysis membrane with absorption capacity [3,4,5,6,7]. …”

Section: Discussionmentioning

confidence: 99%

“…Therapeutic recommendations include UV phototherapy, gabapentin, capsaicin, tacrolimus ointment and dialysis using absorbing membranes [3]. …”

Section: Introductionmentioning

confidence: 99%

Prurigo Nodularis and Dialyzer Membrane

Goeksel¹,

Xie²,

Ritzerfeld³

et al. 2013

Blood Purif

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Prurigo nodularis is a skin disease with unknown origin which is frequent in patients on maintenance renal replacement therapy. Here, we report a patient who was dialyzed for more than 10 years with different dialyzers using different dialyzer membranes. Each time when the patient was switched to a polymethylmethacrylate membrane (Filtryzer BK-1.6P), itching and skin lesions disappeared completely. This effect could be verified three times.

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“…Protein-bound uremic toxins are, in fact, small in size but become larger molecular weight compounds (50,000 -200,000 Dalton) once are bound to different types of proteins depending on their binding affinity. Protein-bound uremic toxins have been potentially involved in important uremia co-morbidities such as itching and altered immune response caused by the retained and deposited free molecules (κ-type and λ-type) of the immunoglobulin light chain in internal organs [92][93][94][95].…”

Section: Adsorption Hemodialysismentioning

confidence: 99%

“…The use of PMMA membranes has been shown to ameliorate the severity and frequency of pruritis [95] in HD patients due to adsorption of a 160,000 Dalton molecular weight molecule with stimulatory effect on mast cells [100]. PMMA membranes also efficiently adsorb β 2 -M (representative of middle molecules), where they have been shown to improve carpal tunnel syndrome or total joint pain score in HD patients [99].…”

Section: Adsorption Hemodialysismentioning

confidence: 99%

Advances in Hemodialysis Techniques

Karkar¹

2013

Hemodialysis

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Review: the effect of polymethylmethacrylate dialysis membranes on uraemic pruritus

Cited by 23 publications

References 26 publications

Adsorption Dialysis: From Physical Principles to Clinical Applications

Adsorption Dialysis: From Physical Principles to Clinical Applications

Prurigo Nodularis and Dialyzer Membrane

Advances in Hemodialysis Techniques

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