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Prospective evaluation of the change of predialysis protein-bound uremic solute concentration with postdilution online hemodiafiltration

(2010) ARTIFICIAL ORGANS. 34(7). p.580-585
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Abstract
Although protein-bound uremic compounds have been related to outcome in observational studies, few current dialysis strategies provide more removal of those compounds than standard hemodialysis. We evaluated the evolution of protein-bound uremic solutes after a switch from high-flux hemodialysis to postdilution hemodiafiltration (n = 13). We compared predialysis solute concentration at 4, 5, and 9 weeks versus baseline for several protein-bound compounds and water-soluble solutes, as well as for beta(2)-microglobulin. After 9 weeks of postdilution hemodiafiltration, a significant decrease versus baseline could be detected for total concentration of protein-bound solutes: p-cresylsulfate (3.98 +/- 1.51-3.17 +/- 1.77 mg/dL, -20%, P < 0.01) and 3-carboxyl-4-methyl-5-propyl-2-furanpropionic acid (0.72 +/- 0.52-0.64 +/- 0.46 mg/dL, -11%, P < 0.01). For the other protein-bound solutes, hippuric acid, indoleacetic acid, and indoxylsulfate, no change in total concentration could be detected. The concentration of the middle molecule, beta(2)-microglobulin, decreased as well after 9 weeks of postdilution hemodiafiltration (24.7 +/- 9.3-18.1 +/- 6.7 mg/L, -27%, P < 0.01). For water-soluble compounds, no significant change of concentration was found. Postdilution hemodiafiltration in comparison to high-flux hemodialysis provided significant reduction of predialysis concentration of protein-bound compounds, especially those with the highest protein binding, and of beta(2)-microglobulin, by -11 to -27% in 9 weeks.
Keywords
INDOXYL SULFATE, HEMODIALYSIS-PATIENTS, FREE P-CRESOL, Protein binding, Uremic toxins, Postdilution, Hemodialysis, Hemodiafiltration, FLUX HEMODIALYSIS, REMOVAL, TOXINS, DISEASE

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Citation

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Chicago
Meert, Natalie, MARIA WATERLOOS, Maria Van Landschoot, Annemieke Dhondt, Ingid Ledebo, Griet Glorieux, Jan Goeman, Johan Van der Eycken, and Raymond Vanholder. 2010. “Prospective Evaluation of the Change of Predialysis Protein-bound Uremic Solute Concentration with Postdilution Online Hemodiafiltration.” Artificial Organs 34 (7): 580–585.
APA
Meert, N., WATERLOOS, M., Van Landschoot, M., Dhondt, A., Ledebo, I., Glorieux, G., Goeman, J., et al. (2010). Prospective evaluation of the change of predialysis protein-bound uremic solute concentration with postdilution online hemodiafiltration. ARTIFICIAL ORGANS, 34(7), 580–585.
Vancouver
1.
Meert N, WATERLOOS M, Van Landschoot M, Dhondt A, Ledebo I, Glorieux G, et al. Prospective evaluation of the change of predialysis protein-bound uremic solute concentration with postdilution online hemodiafiltration. ARTIFICIAL ORGANS. 2010;34(7):580–5.
MLA
Meert, Natalie, MARIA WATERLOOS, Maria Van Landschoot, et al. “Prospective Evaluation of the Change of Predialysis Protein-bound Uremic Solute Concentration with Postdilution Online Hemodiafiltration.” ARTIFICIAL ORGANS 34.7 (2010): 580–585. Print.
@article{1176767,
  abstract     = {Although protein-bound uremic compounds have been related to outcome in observational studies, few current dialysis strategies provide more removal of those compounds than standard hemodialysis. We evaluated the evolution of protein-bound uremic solutes after a switch from high-flux hemodialysis to postdilution hemodiafiltration (n = 13). We compared predialysis solute concentration at 4, 5, and 9 weeks versus baseline for several protein-bound compounds and water-soluble solutes, as well as for beta(2)-microglobulin. After 9 weeks of postdilution hemodiafiltration, a significant decrease versus baseline could be detected for total concentration of protein-bound solutes: p-cresylsulfate (3.98 +/- 1.51-3.17 +/- 1.77 mg/dL, -20\%, P {\textlangle} 0.01) and 3-carboxyl-4-methyl-5-propyl-2-furanpropionic acid (0.72 +/- 0.52-0.64 +/- 0.46 mg/dL, -11\%, P {\textlangle} 0.01). For the other protein-bound solutes, hippuric acid, indoleacetic acid, and indoxylsulfate, no change in total concentration could be detected. The concentration of the middle molecule, beta(2)-microglobulin, decreased as well after 9 weeks of postdilution hemodiafiltration (24.7 +/- 9.3-18.1 +/- 6.7 mg/L, -27\%, P {\textlangle} 0.01). For water-soluble compounds, no significant change of concentration was found. Postdilution hemodiafiltration in comparison to high-flux hemodialysis provided significant reduction of predialysis concentration of protein-bound compounds, especially those with the highest protein binding, and of beta(2)-microglobulin, by -11 to -27\% in 9 weeks.},
  author       = {Meert, Natalie and WATERLOOS, MARIA and Van Landschoot, Maria and Dhondt, Annemieke and Ledebo, Ingid and Glorieux, Griet and Goeman, Jan and Van der Eycken, Johan and Vanholder, Raymond},
  issn         = {0160-564X},
  journal      = {ARTIFICIAL ORGANS},
  keyword      = {INDOXYL SULFATE,HEMODIALYSIS-PATIENTS,FREE P-CRESOL,Protein binding,Uremic toxins,Postdilution,Hemodialysis,Hemodiafiltration,FLUX HEMODIALYSIS,REMOVAL,TOXINS,DISEASE},
  language     = {eng},
  number       = {7},
  pages        = {580--585},
  title        = {Prospective evaluation of the change of predialysis protein-bound uremic solute concentration with postdilution online hemodiafiltration},
  url          = {http://dx.doi.org/10.1111/j.1525-1594.2010.01005.x},
  volume       = {34},
  year         = {2010},
}

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