title: Choosing new adsorbents for endogenous ultrapure infusion fluid: performances, safety and flow distribution.
abstract: Adsorption may notably contribute to the removal of uremic toxins and to the efficiency of hemodialysis. We examined different uncoated stationary matrixes, charcoals and synthetic resins to establish their adsorptive capacities in relation to low (urea, creatinine) and high molecular weight (beta2-microglobulin, myoglobin) compounds in in vitro conditions (steady state and flow-through) using isotonic solutions or uremic ultrafiltrate. Trace metal, particle release analyses and scanning electron microscopy of different adsorbents were performed. Dynamic flow-distribution studies were made using 99Technetium and analysing the different regions of interest by single head gamma-camera. We show that adsorbents may differ greatly as to their adsorptive capacity depending on flow rate, nature, and total mass of the compounds to be removed from the ultrafiltrate. These studies suggest a methodological approach for screening stationary matrixes for possible application in hemodialysis.
authors.affiliation: Clinical and Laboratory Research Department, Bellco SpA, Mirandola, Italy.
authors.forename: C
authors.initials: C
authors.lastname: De Nitti
authors.forename: R
authors.initials: R
authors.lastname: Giordano
authors.forename: R
authors.initials: R
authors.lastname: Gervasio
authors.forename: G
authors.initials: G
authors.lastname: Castellano
authors.forename: V
authors.initials: V
authors.lastname: Podio
authors.forename: L
authors.initials: L
authors.lastname: Sereni
authors.forename: P M
authors.initials: PM
authors.lastname: Ghezzi
authors.forename: C
authors.initials: C
authors.lastname: Ronco
authors.forename: A
authors.initials: A
authors.lastname: Brendolan
authors.forename: P
authors.initials: P
authors.lastname: Inguaggiato
authors.forename: M
authors.initials: M
authors.lastname: Tonelli
authors.forename: G
authors.initials: G
authors.lastname: La Greca
authors.forename: C
authors.initials: C
authors.lastname: Tetta
mesh_terms: D000327:Adsorption; D003404:Creatinine / Q000097:blood; D017583:Hemodiafiltration / Q000009:adverse effects / Q000295:instrumentation; D015312:Hemodialysis Solutions / Q000032:analysis* / Q000494:pharmacology*; D006801:Humans; D066298:In Vitro Techniques; D007676:Kidney Failure, Chronic / Q000628:therapy; D008855:Microscopy, Electron, Scanning; D009211:Myoglobin / Q000097:blood; D006435:Renal Dialysis / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D014131:Trace Elements / Q000097:blood
chemical_list: D015312:Hemodialysis Solutions; D009211:Myoglobin; D014131:Trace Elements; D003404:Creatinine