Patient‐reported outcomes from the investigational device exemption study of the Tablo hemodialysis system

Chertow, Glenn M.; Álvarez, Luis Octavio Martínez; Plumb, Troy J.; Prichard, Sarah; Aragon, Michael

doi:10.1111/hdi.12869

Cited by 3 publications

(1 citation statement)

References 14 publications

(26 reference statements)

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“…The second aim of this study was to test whether activated carbon could increase the clearances of proteinbound uremic solutes in systems that use low dialysate flows. The desire to make hemodialysis available at home has motivated the development of several such systems (24)(25)(26). All of these systems provide adequate treatment, as assessed by the clearance of urea.…”

Section: Discussionmentioning

confidence: 99%

Removal of Uremic Solutes from Dialysate by Activated Carbon

Lee

Sirich

Blanco

et al. 2022

CJASN

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Background and objectivesAdsorption of uremic solutes to activated carbon provides a potential means to limit dialysate volumes required for new dialysis systems. The ability of activated carbon to take up uremic solutes has, however, not been adequately assessed.Design, setting, participants, & measurementsGraded volumes of waste dialysate collected from clinical hemodialysis treatments were passed through activated carbon blocks. Metabolomic analysis assessed the adsorption by activated carbon of a wide range of uremic solutes. Additional experiments tested the ability of the activated carbon to increase the clearance of selected solutes at low dialysate flow rates.ResultsActivated carbon initially adsorbed the majority, but not all, of 264 uremic solutes examined. Solute adsorption fell, however, as increasing volumes of dialysate were processed. Moreover, activated carbon added some uremic solutes to the dialysate, including methylguanidine. Activated carbon was particularly effective in adsorbing uremic solutes that bind to plasma proteins. In vitro dialysis experiments showed that introduction of activated carbon into the dialysate stream increased the clearance of the protein-bound solutes indoxyl sulfate and p-cresol sulfate by 77%±12% (mean±SD) and 73%±12%, respectively, at a dialysate flow rate of 200 ml/min, but had a much lesser effect on the clearance of the unbound solute phenylacetylglutamine.ConclusionsActivated carbon adsorbs many but not all uremic solutes. Introduction of activated carbon into the dialysate stream increased the clearance of those solutes that it does adsorb.

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Section: Discussionmentioning

confidence: 99%