Title: Enhanced Indoxyl Sulfate Dialyzer Clearance with the Use of Binding Competitors
Abstract: <b><i>Background:</i></b> Indoxyl sulfate is a protein-bound uremic toxin and its dialytic clearance is comparatively low. We propose a method to increase indoxyl sulfate dialytic clearance. <b><i>Methods:</i></b> Human serum albumin, preloaded with indoxyl sulfate, was circulated on the blood side of an F40S dialyzer with single-pass counter-current dialysate flow. Tryptophan or docosahexaenoic acid (DHA), which are binding competitors to indoxyl sulfate, were infused into the blood-side circuit upstream of the dialyzer, and their abilities to increase the removal of indoxyl sulfate determined. <b><i>Results:</i></b> Baseline indoxyl sulfate removal was 10.2 ± 0.3%, which increased to 18.5 ± 0.4% with infusion of tryptophan (p < 0.001) and 27.7 ± 1.0% with infusion of DHA (p < 0.001). <b><i>Conclusions:</i></b> This study shows that tryptophan and DHA effectively increase indoxyl sulfate removal in an in vitro dialysis model. The concept of using binding competitors to enhance the clearance of protein-bound uremic toxins could be applied to current hemodialysis technology.
Publication Year: 2015
Publication Date: 2015-01-01
Language: en
Type: article
Indexed In: ['crossref', 'pubmed']
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Cited By Count: 25
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