Abstract
Presepsin, which is used as a biomarker for sepsis, is thought to be removed by dialysis, but the actual removal properties of dialysis are unknown. We investigated the presepsin removal properties of continuous hemodiafiltration using the high concentration of presepsin from human plasma drained by plasma exchange. Each solution in plasma exchange was connected to a continuous hemodiafiltration blood circuit and circulated at 4 conditions. The results show that presepsin was confirmed to be removed more efficiently in hemofiltration than in hemodialysis. In addition, when using a polymethylmethacrylate hemofilter for continuous hemodiafiltration, the lowest presepsin concentration is on the filtrate side, suggesting that the main removal mechanism is adsorption. Since presepsin has a molecular weight of 13,000, its removal efficiency is high by hemofiltration as per principle. In addition, since the main adsorption principle of polymethylmethacrylate hemofilter is hydrophobic bond, presepsin is considered to be adsorbed. Since presepsin is metabolized in the kidney, it is elevated in renal failure. In this paper, we confirmed that presepsin is eliminated by continuous hemodiafiltration not only in the kidney. Depending on the timing of presepsin measurement, there is a risk of missing the diagnosis of sepsis. Kidney function and continuous hemodiafiltration should be checked when measuring presepsin.
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The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.
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Funding
This study was supported by a Grant for clinical research from Miyazaki University Hospital.
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Tatsumi Yamasaki: This author conceptualized the idea, conducted the experiment, collected data, analyzed data, and prepared the manuscript. Yasuto Miyamoto: This author assisted with the experiment. Takayuki Goto: This author assisted with the experiment. Yuuichi Oda: This author assisted with the experiment and manuscript preparation. Takeshi Yano: This author assisted with the manuscript preparation. Masahiko Taniguchi: This author assisted with the experiment. Tetsuro Shirasaka: This author assisted with the manuscript preparation.
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The authors have no conflicts of interest with any medical device or company.
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Yamasaki, T., Miyamoto, Y., Goto, T. et al. Removal characteristics of presepsin by operating conditions and hemofilter. J Artif Organs (2023). https://doi.org/10.1007/s10047-023-01424-w
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DOI: https://doi.org/10.1007/s10047-023-01424-w