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Hemoperfusion and Removal of Endogenous Uremic Middle Molecules

  • R. Oulès
  • H. Asaba
  • M. Neuhäuser
  • V. Yahiel
  • S. Bæhrendtz
  • B. Gunnarsson
  • J. Bergström
  • P. Fürst

Abstract

According to the middle molecule hypothesis (1), uremic solutes in the molecular weight range of 350 to 2,000 daltons are assumed to be toxic and evidence has been brought forward that uremic patients accumulate these substances in their body fluids (2–6). Serum middle molecule levels determined by gel filtration were reported by Chang et al. (7) to be more reduced following 2 hours of hemoperfusion than after hemodialysis for 6 to 10 hours as found by Dzurik et al. (8).

Keywords

Inlet Concentration Uremic Patient Molecular Weight Range Middle Molecule Charcoal Haemoperfusion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Babb, A.L., Farrell, P.D., Uvelii, D.A., and Scribner, B.H., Hemodialyzer evaluation by examination of solute molecular spectra. Trans. Am. Soc. Artif. Intern. Organs 18, 98, 1972.PubMedCrossRefGoogle Scholar
  2. 2.
    Dall’Aglio, P., Buzio, C., Cambi, V., Arisi, L., and Migone, L., La retention de moyennes molecules dans le serum uremique. Proc. Eur. Dialysis Transplant Ass. 9, 408, 1972.Google Scholar
  3. 3.
    Gajdos, M., and Dzurik, R., Erythrocyte glycolysis in uraemia; dynamic balance caused by the opposite action of various factors. Int. Urol. Nephrol. 5, 331, 1973.CrossRefGoogle Scholar
  4. 4.
    Man, N.K., Terlain, B., Paris, J., Werner, G., Sausse, A., and Funck-Brentano, J.-L., An approach to “middle molecules” identification in artificial kidney dialysate, with reference to neuropathy prevention. Trans. Am. Soc. Artif. Intern. Organs 19, 320, 1973.PubMedCrossRefGoogle Scholar
  5. 5.
    Migone, L., Dall’Aglio, P., and Buzio, C, Middle molecules in uremic serum, urine and dialysis fluid. Clin. Nephrol. 3, 82, 1975.PubMedGoogle Scholar
  6. 6.
    Funck-Brentano, J.L., Man, N.K., Sausse, A., Zingraff, J., Boudet, J., Becker, A., and Cueille, G. F., Characterization of a 1100–1300 MW uremic neurotoxin. Trans. Am. Soc. Artif. Intern. Organs 22, 163, 1976.PubMedGoogle Scholar
  7. 7.
    Chang, T.M.S., Migchelsen, M., Coffey, J. F., and Stark, A., Serum middle molecule levels in uremia during long term intermittent hemoperfusions with the ACAC (coated charcoal) microcapsule artificial kidney. Trans. Am. Soc. Artif. Intern. Organs 20, 364, 1974.Google Scholar
  8. 8.
    Dzurik, R., Bozek, P., Reznicek, J., and Obornikova, A., Blood level of middle molecular substances during uraemia and haemodialysis. Proc. Eur. Dialysis Transplant Ass. 10, 263, 1973.Google Scholar
  9. 9.
    Fürst, P., Zimmerman, L., and Bergström, J., Determination of endogenous middle molecules in normal and uremic body fluids. Clin. Nephrol. 5, 178, 1976.Google Scholar
  10. 10.
    Oulès, R., Asaba, H., Neuhäuser, M., Yahiel, V., Gunnarsson, B., Bergström, J., and Fürst, P., The removal of uremic small and middle molecules and free amino acids by carbon hemoperfusion. Trans. Am. Soc. Artif. Intern. Organs, in press.Google Scholar
  11. 11.
    ‘Sorbents’, Kidney Int. 10, Suppl. 7, S-209, 1976.Google Scholar
  12. 12.
    Yatzidis, H., A convenient haemoperf us ion micro-apparatus over charcoal for the treatment of endogenous and exogenous intoxication. Proc. Eur. Dialysis Transplant Ass., 1, 83, 1965.Google Scholar
  13. 13.
    Gazzard, B.G., Portmann, B.A., Weston, M.J., Langley, P.G., Murray-Lyon, I.M., Dunlop, E.H., Flax, H., Mellon, P.J., Record, C.O., Ward, M.B., and Williams, R., Charcoal haemoperf us ion in the treatment of fulminant hepatic failure. Lancet 1, 1301, 1974.PubMedCrossRefGoogle Scholar
  14. 14.
    Vale, J. A., Rees, A.J., Widdop, B., and Goulding, R., Use of charcoal haemoperfusion in the management of severely poisoned patients. Br. Med. J. 1, 5, 1975.PubMedCrossRefGoogle Scholar
  15. 15.
    Winchester, J.F., Apiliga, M.T., and Kennedy, A.C., Short-term evaluation of charcoal hemoperfusion combined with dialysis in uremic patients. Kidney Int. 10, S-315, 1976.Google Scholar
  16. 16.
    Chang, T.M.S., Hemoperfusion alone and in series with ultrafiltration or dialysis for uremia, poisoning and liver failure. Kidney Int. 10, S-305, 1976.Google Scholar
  17. 17.
    Neuhäuser, M., Untersuchungen zur Elimination von Endprodukten des Proteinstoffwechsels durch Hämodialyse oder Hämoperfusion bei Patienten mit chronischer Niereninsuffizienz. Thesis, Jus tus-Lieb ig-Universität, Giessen, West-Germany, 1976.Google Scholar
  18. 18.
    Goubeaud, G., and Schott, H.H., Aufrennung von “Mittelmolekülen” im Urämikerserum durch Molekularsiebchromatographie. Klin. Wochen-schr., in press.Google Scholar
  19. 19.
    Bergström, J., and Fürst, P., Uremic middle molecules. Clin. Nephrol. 5, 143, 1976.PubMedGoogle Scholar
  20. 20.
    Chang, T.M.S., Chirito, E., Barre, B., Cole, C, and Hewish, M., Clinical performance-characteristics of anew combined system for simultaneous hemoperfusion-hemodiaiysis-ultrafiltration in series. Trans. Am. Soc. Artif. Int. Organs 21, 502, 1975.Google Scholar

Copyright information

© Plenum Press, New York 1978

Authors and Affiliations

  • R. Oulès
    • 1
  • H. Asaba
    • 1
  • M. Neuhäuser
    • 1
  • V. Yahiel
    • 1
  • S. Bæhrendtz
    • 1
  • B. Gunnarsson
    • 1
  • J. Bergström
    • 1
  • P. Fürst
    • 1
  1. 1.Metabolic Research Laboratory and the Dept of NephrologySt. Eriks sjukhusStockholmSweden

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