BACKGROUND: Additional small-solute clearances during standard thrice-weekly hemodialysis treatments have not improved patient survival. However, these treatments have limited middle-molecule clearances. Thus, newer therapies designed to increase middle-molecule clearances need to be developed and evaluated. STUDY DESIGN: Pilot clinical trial to measure beta(2)-microglobulin and phosphate clearances with a wearable hemodialysis device. SETTING & PARTICIPANTS: 8 regular hemodialysis patients under the care of a university teaching hospital. INTERVENTION: Patients were fitted with a wearable hemodialysis device for 4 to 8 hours. OUTCOMES: All patients tolerated the treatment. RESULTS: Average amount of beta(2)-microglobulin removed was 99.8 +/- 63.1 mg, with mean clearance of 11.3 +/- 2.3 mL/min, and an average of 445.2 +/- 326 mg of phosphate was removed, with mean plasma phosphate clearance of 21.7 +/- 4.5 mL/min. These clearances compared favorably with mean urea and creatinine plasma clearances (21.8 +/- 1.6 and 20.0 +/- 0.8 mL/min, respectively). LIMITATIONS: Proof-of-concept preliminary trial. Additional studies are warranted to confirm these positive preliminary data. CONCLUSIONS: This wearable artificial kidney potentially provides effective beta(2)-microglobulin and phosphate clearances and, by analogy, middle-molecule clearances.
BACKGROUND: Additional small-solute clearances during standard thrice-weekly hemodialysis treatments have not improved patient survival. However, these treatments have limited middle-molecule clearances. Thus, newer therapies designed to increase middle-molecule clearances need to be developed and evaluated. STUDY DESIGN: Pilot clinical trial to measure beta(2)-microglobulin and phosphate clearances with a wearable hemodialysis device. SETTING & PARTICIPANTS: 8 regular hemodialysis patients under the care of a university teaching hospital. INTERVENTION: Patients were fitted with a wearable hemodialysis device for 4 to 8 hours. OUTCOMES: All patients tolerated the treatment. RESULTS: Average amount of beta(2)-microglobulin removed was 99.8 +/- 63.1 mg, with mean clearance of 11.3 +/- 2.3 mL/min, and an average of 445.2 +/- 326 mg of phosphate was removed, with mean plasma phosphate clearance of 21.7 +/- 4.5 mL/min. These clearances compared favorably with mean urea and creatinine plasma clearances (21.8 +/- 1.6 and 20.0 +/- 0.8 mL/min, respectively). LIMITATIONS: Proof-of-concept preliminary trial. Additional studies are warranted to confirm these positive preliminary data. CONCLUSIONS: This wearable artificial kidney potentially provides effective beta(2)-microglobulin and phosphate clearances and, by analogy, middle-molecule clearances.
Authors: Victor Gura; Matthew B Rivara; Scott Bieber; Raj Munshi; Nancy Colobong Smith; Lori Linke; John Kundzins; Masoud Beizai; Carlos Ezon; Larry Kessler; Jonathan Himmelfarb Journal: JCI Insight Date: 2016-06-02
Authors: Victor Gura; Alexandra S Macy; Masoud Beizai; Carlos Ezon; Thomas A Golper Journal: Clin J Am Soc Nephrol Date: 2009-08-20 Impact factor: 8.237
Authors: Farah Tasnim; Rensheng Deng; Min Hu; Sean Liour; Yao Li; Ming Ni; Jackie Y Ying; Daniele Zink Journal: Fibrogenesis Tissue Repair Date: 2010-08-10