Sorbents in Acute Renal Failure and End-Stage Renal Disease: Middle Molecule and Cytokine Removal

Renal replacement therapy in acute renal failure (ARF) and chronic renal failure (end-stage renal disease; ESRD) has been based on the use of modifications of dialysis (continuous arteriovenous hemofiltration and hemodiafiltration) to remove middle-molecular-weight toxins, consisting of low-molecula...

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Veröffentlicht in:Blood purification 2004-01, Vol.22 (1), p.73-77
Hauptverfasser: Winchester, James F., Silberzweig, Jeffrey, Ronco, Claudio, Kuntsevich, Viktoria, Levine, Daniel, Parker, Tom, Kellum, John A., Salsberg, Jamie A., Quartararo, Peter, Levin, Nathan W.
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container_end_page 77
container_issue 1
container_start_page 73
container_title Blood purification
container_volume 22
creator Winchester, James F.
Silberzweig, Jeffrey
Ronco, Claudio
Kuntsevich, Viktoria
Levine, Daniel
Parker, Tom
Kellum, John A.
Salsberg, Jamie A.
Quartararo, Peter
Levin, Nathan W.
description Renal replacement therapy in acute renal failure (ARF) and chronic renal failure (end-stage renal disease; ESRD) has been based on the use of modifications of dialysis (continuous arteriovenous hemofiltration and hemodiafiltration) to remove middle-molecular-weight toxins, consisting of low-molecular-weight proteins and peptides (LMWP) and cytokines involved in inflammation. High-flux dialyzers are not efficient at removing LMWP, and for this reason, sorbents have been studied to augment or replace dialysis. Removal of LMWP such as β 2 -microglobulin, leptin, complement factor D, angiogenin and cytokines such as interleukin (IL)-1, IL-6, IL-10, IL-18 and tumor necrosis factor-α has been established in animal models of sepsis and in ESRD patients using sorbents. Sorbent devices added to hemodialysis, or the use of such devices alone in inflammatory states, including sepsis, ARF, cardiopulmonary bypass, pre-explantation of donor organs and ESRD, are being studied.
doi_str_mv 10.1159/000074926
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Renal failure</subject><subject>Peptides - blood</subject><subject>Renal failure</subject><subject>Resins, Synthetic - chemistry</subject><subject>Sepsis - blood</subject><subject>Sepsis - therapy</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. 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Renal failure</topic><topic>Peptides - blood</topic><topic>Renal failure</topic><topic>Resins, Synthetic - chemistry</topic><topic>Sepsis - blood</topic><topic>Sepsis - therapy</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. 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subjects Acute Kidney Injury - blood
Acute Kidney Injury - therapy
Adsorption
Adult
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Animals
Biological and medical sciences
Blood Proteins - metabolism
Clinical Trials as Topic
Cytokines - blood
Emergency and intensive care: renal failure. Dialysis management
Female
Hemoperfusion - methods
Humans
Inflammation - blood
Intensive care medicine
Kidney Failure, Chronic - blood
Kidney Failure, Chronic - therapy
Male
Medical sciences
Middle Aged
Molecular Weight
Nephrology. Urinary tract diseases
Nephropathies. Renovascular diseases. Renal failure
Peptides - blood
Renal failure
Resins, Synthetic - chemistry
Sepsis - blood
Sepsis - therapy
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the urinary system
Treatment Outcome
title Sorbents in Acute Renal Failure and End-Stage Renal Disease: Middle Molecule and Cytokine Removal
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