title: An adsorbent monolith device to augment the removal of uraemic toxins during haemodialysis.
abstract: Adsorbents designed with porosity which allows the removal of protein bound and high molecular weight uraemic toxins may improve the effectiveness of haemodialysis treatment of chronic kidney disease (CKD). A nanoporous activated carbon monolith prototype designed for direct blood contact was first assessed for its capacity to remove albumin bound marker toxins indoxyl sulphate (IS), p-cresyl sulphate (p-CS) and high molecular weight cytokine interleukin-6 in spiked healthy donor studies. Haemodialysis patient blood samples were then used to measure the presence of these markers in pre- and post-dialysis blood and their removal by adsorbent recirculation of post-dialysis blood samples. Nanopores (20-100 nm) were necessary for marker uraemic toxin removal during in vitro studies. Limited removal of IS and p-CS occurred during haemodialysis, whereas almost complete removal occurred following perfusion through the carbon monoliths suggesting a key role for such adsorbent therapies in CKD patient care.
authors.affiliation: Biomaterials and Medical Devices Research Group, School of Pharmacy and Biomolecular Sciences, University of Brighton, Huxley Building, Lewes Road, Brighton, East Sussex, BN2 4GJ, UK, s.sandeman@brighton.ac.uk.
authors.forename: Susan R
authors.initials: SR
authors.lastname: Sandeman
authors.forename: Carol A
authors.initials: CA
authors.lastname: Howell
authors.forename: Gary J
authors.initials: GJ
authors.lastname: Phillips
authors.forename: Yishan
authors.initials: Y
authors.lastname: Zheng
authors.forename: Guy
authors.initials: G
authors.lastname: Standen
authors.forename: Robert
authors.initials: R
authors.lastname: Pletzenauer
authors.forename: Andrew
authors.initials: A
authors.lastname: Davenport
authors.forename: Kolitha
authors.initials: K
authors.lastname: Basnayake
authors.forename: Owen
authors.initials: O
authors.lastname: Boyd
authors.forename: Stephen
authors.initials: S
authors.lastname: Holt
authors.forename: Sergey V
authors.initials: SV
authors.lastname: Mikhalovsky
mesh_terms: D000042:Absorption; D002606:Charcoal / Q000737:chemistry*; D003408:Cresols / Q000097:blood / Q000302:isolation & purification*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D006440:Hemofiltration / Q000295:instrumentation*; D006801:Humans; D007200:Indican / Q000097:blood / Q000302:isolation & purification*; D015850:Interleukin-6 / Q000097:blood / Q000302:isolation & purification*; D008422:Materials Testing; D008567:Membranes, Artificial; D010865:Pilot Projects; D006435:Renal Dialysis / Q000295:instrumentation*; D013463:Sulfuric Acid Esters / Q000097:blood / Q000302:isolation & purification*; D014511:Uremia / Q000097:blood* / Q000517:prevention & control
chemical_list: D003408:Cresols; D015850:Interleukin-6; D008567:Membranes, Artificial; D013463:Sulfuric Acid Esters; D002606:Charcoal; C408690:4-cresol sulfate; D007200:Indican