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A Bifunctional Adsorber Particle for the Removal of Hydrophobic Uremic Toxins from Whole Blood of Renal Failure Patients

1
Institute for Molecular Cardiovascular Research (IMCAR), University Hospital Aachen, RWTH Aachen University, 52074 Aachen, Germany
2
Institute for Occupational, Social and Environmental Medicine; University Hospital Aachen, RWTH Aachen University, 52074 Aachen, Germany
3
Institute of Inorganic Chemistry, RWTH Aachen University, 52056 Aachen, Germany
4
PSS Polymer Standards Service GmbH, 55120 Mainz, Germany
5
Fresenius Medical Care Deutschland GmbH, 66606 St. Wendel, Germany
6
Fresenius Medical Care Deutschland GmbH, 61352 Bad Homburg, Germany
7
Department of Internal Medicine—Nephrology and Hypertension, Saarland University Medical Centre, 66421 Homburg/Saar, Germany
8
Medical Clinic I—Cardiology, University Hospital RWTH Aachen, 52074 Aachen, Germany
9
School for Cardiovascular Diseases, Maastricht University, 6200 Maastricht, The Netherlands
10
European Uremic Toxin Work Group-EUTox, Danube University Krems, 3500 Krems, Austria
*
Author to whom correspondence should be addressed.
Toxins 2019, 11(7), 389; https://doi.org/10.3390/toxins11070389
Received: 2 May 2019 / Revised: 29 June 2019 / Accepted: 1 July 2019 / Published: 3 July 2019
(This article belongs to the Section Uremic Toxins)
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PDF [1132 KB, uploaded 10 July 2019]
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Abstract

Hydrophobic uremic toxins accumulate in patients with chronic kidney disease, contributing to a highly increased cardiovascular risk. The clearance of these uremic toxins using current hemodialysis techniques is limited due to their hydrophobicity and their high binding affinity to plasma proteins. Adsorber techniques may be an appropriate alternative to increase hydrophobic uremic toxin removal. We developed an extracorporeal, whole-blood bifunctional adsorber particle consisting of a porous, activated charcoal core with a hydrophilic polyvinylpyrrolidone surface coating. The adsorption capacity was quantified using analytical chromatography after perfusion of the particles with an albumin solution or blood, each containing mixtures of hydrophobic uremic toxins. A time-dependent increase in hydrophobic uremic toxin adsorption was depicted and all toxins showed a high binding affinity to the adsorber particles. Further, the particle showed a sufficient hemocompatibility without significant effects on complement component 5a, thrombin-antithrombin III complex, or thrombocyte concentration in blood in vitro, although leukocyte counts were slightly reduced. In conclusion, the bifunctional adsorber particle with cross-linked polyvinylpyrrolidone coating showed a high adsorption capacity without adverse effects on hemocompatibility in vitro. Thus, it may be an interesting candidate for further in vivo studies with the aim to increase the efficiency of conventional dialysis techniques. View Full-Text
Keywords: activated charcoal; hemodialysis; adsorption; uremic toxins; hemocompatibility; chronic kidney disease activated charcoal; hemodialysis; adsorption; uremic toxins; hemocompatibility; chronic kidney disease
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Sternkopf, M.; Thoröe-Boveleth, S.; Beck, T.; Oleschko, K.; Erlenkötter, A.; Tschulena, U.; Steppan, S.; Speer, T.; Goettsch, C.; Jankowski, V.; Jankowski, J.; Noels, H.; The European Uremic Toxin Work Group-EUTox. A Bifunctional Adsorber Particle for the Removal of Hydrophobic Uremic Toxins from Whole Blood of Renal Failure Patients. Toxins 2019, 11, 389.

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