Perfusion of Uremic Blood Ultrafiltrate on Uncoated Charcoal

Politi, Laura; Cerulli, Nicola; D’Angelo, Anna; Scandurra, Roberto

doi:10.1111/j.1525-1594.1989.tb02871.x

Artificial Organs

1989

DOI: 10.1111/j.1525-1594.1989.tb02871.x

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Perfusion of Uremic Blood Ultrafiltrate on Uncoated Charcoal

Laura Politi

Nicola Cerulli

Anna D’Angelo

et al.

Abstract: A granular uncoated charcoal removes from uremic blood ultrafiltrates many chemical species that are not removed by dialysis. Charcoal treatment dramatically improves the general condition of the patients and normalizes their blood pressure. To obtain a rapid depuration, the initial treatment should be intensive (at least 16 daily treatments) and the effects prolonged over time by once-a-week charcoal treatment between two standard hemodialyses. Biogel P2 chromatography documents well all the events of a depur… Show more

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Cited by 4 publications

References 9 publications

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Hemodiafiltration with online regeneration of the ultrafiltrate

Francisco¹,

Ghezzi²,

Brendolan³

et al. 2000

Kidney International

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Hemodiafiltration with online regeneration of the ultrafiltrate. technique. Different techniques either increase diffusionThe concept of regeneration of dialysis fluids and of ultrafiltrate (high dialyzer surfaces) or convection (high ultrafiltration in particular has been recently revisited. Hemodiafiltration with rates, high infusion volumes). From renal physiology, online regeneration of the ultrafiltrate allows the concomitant urine formation begins with the filtration (convection) of infusion of sodium, calcium, and bicarbonate. Here, we studied essentially protein-free plasma through the glomerular capthe adsorptive characteristics of an integrated two-step sorbent system relative to different solutes present in the ultrafiltrate: illaries. The final urine is quite different from the glomerusodium, calcium, phosphate, bicarbonate, uric acid, creatinine, lar filtrate because, as the fluid flows through the tubule, and ␤ 2 -microglobulin. In vitro studies were performed in order

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Hemodiafiltration with online regeneration of the ultrafiltrate

Francisco¹,

Ghezzi²,

Brendolan³

et al. 2000

Kidney International

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Hemodiafiltration in Two Chambers Without Replacement Fluid: A Clinical Study

Sanz-Moreno

Botella²

1995

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Paired filtration dialysis (PFD) is the only hemodiafiltration (HDF) technique in which ultrafiltrate (Uf) is obtained continuously with a similar composition to plasma. It has been proved that Uf is regenerated when it passes through an uncoated adsorbent charcoal cartridge: this one removes medium-to-large solutes and small toxines (except for urea and phosphates), but not the electrolytes and bicarbonate. This regenerated Uf can be used like replacement fluid, using the same Uf pump as the infusion pump; this makes the HDF technique easier and more reliable. During 12 months (3 h/3 sessions/week), we treated 13 patients with this PFD-Charcoal technique. These patients were previously on conventional PFD for at least 6 months. The biochemical results were excellent with a stabilization of all parameters (urea, creatinine, uric acid, Na, K, Cl, Ca, phosphates, beta 2-microglobulin, beta 2M, etc.) and a better control of acidosis (statistically significative after 6 months). The clinical tolerance was also excellent, and the technique was greatly simplified. We conclude that PFD-Charcoal is a good HDF technique that avoids the use of exogenous replacement fluid by using the regenerated Uf itself as an endogenous substitution fluid with bicarbonate.

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Choosing New Adsorbents for Endogenous Ultrapure Infusion Fluid: Performances, Safety and Flow Distribution

Nitti¹,

Giordano²,

Gervasio³

et al. 2001

Int J Artif Organs

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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 (β2-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 γ-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.

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Perfusion of Uremic Blood Ultrafiltrate on Uncoated Charcoal

Cited by 4 publications

References 9 publications

Hemodiafiltration with online regeneration of the ultrafiltrate

Hemodiafiltration with online regeneration of the ultrafiltrate

Hemodiafiltration in Two Chambers Without Replacement Fluid: A Clinical Study

Choosing New Adsorbents for Endogenous Ultrapure Infusion Fluid: Performances, Safety and Flow Distribution

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