title: In vitro study of removal of protein-bound toxins.
abstract: Protein-bound toxins are not efficiently removed by conventional hemodialysis techniques. In order to improve the removal of protein-bound toxins, we performed an in vitro study to evaluate the effects of dilution and pH change on the dissociation of protein-bound toxins from albumin. Human plasma harvested by therapeutic apheresis treatment was diluted with saline or isotonic NaHCO3 solution, and the amounts of the free fractions of indoxyl sulfate (IS) and homocysteine were determined. The results suggested that IS was dissociated easily from albumin by dilution and pH change; higher dilution was associated with more effective removal and a greater increase of the free fraction of IS. However, these methods did not facilitate dissociation of homocysteine from albumin. Effective removal of some protein-bound toxins may be achieved by applying dilution and pH change methods to blood purification techniques, such as pre-dilution on-line hemodiafiltration.
authors: Department of Clinical Engineering, Tokyo Women's Medical University, Tokyo, Japan. k-yamamoto@twmu.ac.jp
authors: Ken-ichiro
authors: K
authors: Yamamoto
authors: Kei
authors: K
authors: Eguchi
authors: Iwakazu
authors: I
authors: Kaneko
authors: Takashi
authors: T
authors: Akiba
authors: Michio
authors: M
authors: Mineshima
mesh_terms: D001774:Blood Chemical Analysis; D001798:Blood Proteins / Q000378:metabolism; D017583:Hemodiafiltration / Q000379:methods; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000628:therapy; D011485:Protein Binding; D014511:Uremia / Q000097:blood* / Q000209:etiology / Q000628:therapy*
chemical_list: D001798:Blood Proteins