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Ulrich Tschulena
Fresenius Medical Care Deutschland GmbH, 61352 Bad Homburg, Germany

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Journal article
Published: 03 July 2019 in Toxins
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Hydrophobic uremic toxins accumulate in patients with chronic kidney disease, contributing to a highly increased cardiovascular risk. The clearance of these uremic toxins using current hemodialysis techniques is limited due to their hydrophobicity and their high binding affinity to plasma proteins. Adsorber techniques may be an appropriate alternative to increase hydrophobic uremic toxin removal. We developed an extracorporeal, whole-blood bifunctional adsorber particle consisting of a porous, activated charcoal core with a hydrophilic polyvinylpyrrolidone surface coating. The adsorption capacity was quantified using analytical chromatography after perfusion of the particles with an albumin solution or blood, each containing mixtures of hydrophobic uremic toxins. A time-dependent increase in hydrophobic uremic toxin adsorption was depicted and all toxins showed a high binding affinity to the adsorber particles. Further, the particle showed a sufficient hemocompatibility without significant effects on complement component 5a, thrombin-antithrombin III complex, or thrombocyte concentration in blood in vitro, although leukocyte counts were slightly reduced. In conclusion, the bifunctional adsorber particle with cross-linked polyvinylpyrrolidone coating showed a high adsorption capacity without adverse effects on hemocompatibility in vitro. Thus, it may be an interesting candidate for further in vivo studies with the aim to increase the efficiency of conventional dialysis techniques.

ACS Style

Marieke Sternkopf; Sven Thoröe-Boveleth; Tobias Beck; Kirsten Oleschko; Ansgar Erlenkötter; Ulrich Tschulena; Sonja Steppan; Thimoteus Speer; Claudia Goettsch; Vera Jankowski; Joachim Jankowski; Heidi Noels; The European Uremic Toxin Work Group-EUTox. A Bifunctional Adsorber Particle for the Removal of Hydrophobic Uremic Toxins from Whole Blood of Renal Failure Patients. Toxins 2019, 11, 389 .

AMA Style

Marieke Sternkopf, Sven Thoröe-Boveleth, Tobias Beck, Kirsten Oleschko, Ansgar Erlenkötter, Ulrich Tschulena, Sonja Steppan, Thimoteus Speer, Claudia Goettsch, Vera Jankowski, Joachim Jankowski, Heidi Noels, The European Uremic Toxin Work Group-EUTox. A Bifunctional Adsorber Particle for the Removal of Hydrophobic Uremic Toxins from Whole Blood of Renal Failure Patients. Toxins. 2019; 11 (7):389.

Chicago/Turabian Style

Marieke Sternkopf; Sven Thoröe-Boveleth; Tobias Beck; Kirsten Oleschko; Ansgar Erlenkötter; Ulrich Tschulena; Sonja Steppan; Thimoteus Speer; Claudia Goettsch; Vera Jankowski; Joachim Jankowski; Heidi Noels; The European Uremic Toxin Work Group-EUTox. 2019. "A Bifunctional Adsorber Particle for the Removal of Hydrophobic Uremic Toxins from Whole Blood of Renal Failure Patients." Toxins 11, no. 7: 389.

Randomized controlled trial
Published: 04 November 2015 in BMC Nephrology
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A representative cross-sectional study showed that chronic itch (lasting for a minimum of 6 weeks) affects 25.2 % (point prevalence) of hemodialysis (HD) patients. Pathophysiology and etiology of chronic itch (CI) in HD are still unclear. We investigated 860 HD patients from a representative randomly selected cluster-sample considering the regional distributions of dialysis units in GermanyThe current analyses report comorbidities, laboratory values and dialysis characteristics of HD patients in relation to CI. Diabetes was the only comorbidity that was associated with the occurrence of itch but interestingly with less CI. Except for creatinine, phosphorus, and parathormone, there were no significant associations between the occurrence and characteristics of CI and any laboratory value. Kt/V was not associated with the presence of CI. Patients dialyzed with polyarylethersulfone-membrane showed significantly more CI in all prevalence estimates and those dialyzed with polysulfone-membrane were significantly less affected by CI. Long-term follow-up studies will show if the type of dialysis membrane influences the development of CI in HD patients. It is most likely that several factors e.g. elevated parathormone, origin of end stage renal disease (ESRD), type of dialysis membrane, and a neuropathic component all contribute to the occurrence of CI in HD patients. Future research should consider a multifactorial origin of itch in HD.

ACS Style

Elke Weisshaar; Melanie Weiss; Jutta Passlick-Deetjen; Ulrich Tschulena; Klaudia Maleki; Thomas Mettang. Laboratory and dialysis characteristics in hemodialysis patients suffering from chronic itch - results from a representative cross-sectional study. BMC Nephrology 2015, 16, 1 -8.

AMA Style

Elke Weisshaar, Melanie Weiss, Jutta Passlick-Deetjen, Ulrich Tschulena, Klaudia Maleki, Thomas Mettang. Laboratory and dialysis characteristics in hemodialysis patients suffering from chronic itch - results from a representative cross-sectional study. BMC Nephrology. 2015; 16 (1):1-8.

Chicago/Turabian Style

Elke Weisshaar; Melanie Weiss; Jutta Passlick-Deetjen; Ulrich Tschulena; Klaudia Maleki; Thomas Mettang. 2015. "Laboratory and dialysis characteristics in hemodialysis patients suffering from chronic itch - results from a representative cross-sectional study." BMC Nephrology 16, no. 1: 1-8.