Removal of aluminoxamine and ferrioxamine by charcoal hemoperfusion and hemodialysis

Removal of aluminoxamine and ferrioxamine by charcoal hemoperfusion and hemodialysis. We studied the removal of aluminoxamine (AlO) and ferrioxamine (FO) by (i) hemoperfusion/hemodialysis using an AluKartR in combination with either a CuprophanR F-120 or a He-mophanR FH-160 membrane, or (ii) hemodialysis with a high-flux F-60 polysulfone membrane. The same six dialysis patients underwent in a random order dialysis by the three set-ups after i.v. infusion of 30 mg/kg of desferrioxamine (DFO) during the last half an hour of the preceding dialysis session. The mean ± SD plasma AlO and FO clearances of the AluKartR combined with either a F-120 or FH-160 membrane were 194.3 ± 25.8ml/min (AlO) and 164.2 ± 41.3ml (FO) at the start of dialysis declining to respectively 76.6 ± 27.3 and 68.5 ± 42.6ml/min at the end of dialysis. With a high-flux dialysis membrane the intra-dialytic plasma clearance remained constant at 81.5 ± 6.8ml/min for AlO and 60.0 ± 2.8ml/min for FO. In the presence of an AluKartR combined with a FH-160 up to 84 ± 27% and 84 ± 19% of the available AlO and FO could be removed during a four-hour hemoperfusion/hemodialysis session. During the first hour of dialysis, respectively 59 and 58% of the total amount of AlO and FO extracted by the AluKartR was removed compared to only 9 and 16% during the last hour. We conclude that the combined use of hemoperfusion/hemodialysis is highly effective followed closely by a high-flux F-60 membrane in the removal of AlO and FO and in combination with low (5 to 10 mg/kg) DFO doses, may reduce the risk for side effects that have been associated with these compounds.