Albumin dialysis

F. Successful chnical apphcation of extracorporal albumine dialysis in a patient with benign recurrent intrahepatic cholestasis (BRIC). Z. Gastroenterol. 2001 39 (Suppl. 2) 13-14... 

Sturm, E., Franssen, CJtJM., Gouw, A., Staels, B., Boverhof, R., de Knegt, R.J., Stellaard, F., Biileveld, C.MA., Kuipers, F. Extracorporal albumin dialysis (MARS) improves cholestasis and normalizes low apo A-I levels in a patient with benign recurrent intrahepatic cholestasis (BRIC). Liver 2002 22 (Suppl. 2), 72-75... 

Mitzner, St.R., Stange, R., Klammt, S., Risler, T., Erley, C.M., Bader, B.D., Berger, E.D., Lauchart, W., Peszynski, P., Freytag, X, Hickstein, H., Loock, X, Lohr, X-M., Liebe, St., Emmerich, X, Korten, G., Schmidt, R. Improvement of hepatorenal syndrome with extracorporeal albumin dialysis MARS results of a prospective randomized, controlled clinical trial. Liver Transplant. 2000 6 277 — 286... 

Albumin dialysis The aim of albumin dialysis is to remove both soluble metabolites and albumin-bound substances (ABS) from the blood of patients with acute liver failure, (s. tab. 20.5)... 

MET,S The modular extracorporeal hver support system was developed from BELS. In contrast to BELS, however, it consists of three modules (1.) a cell module with human hepatocytes, (2.) single-pass albumin dialysis and (i.) a dialysis module for constant venovenous haemofiltration. (100)... 

Faybik, P., Hetz, H., Baker, A., Bittermann, C., Berlakovich, G., Werba, A., Krenn, C.G., Steltzer, H. Extracorporeal albumin dialysis in patients with Amanita phalloides poisoning. Liver Internat. 2003 23 (Suppl. 3) 28-33... 

Sen, S., Felldin, M., Steiner, C., Lm sson, B., Gillett, G.T., Olausson, M., Williams, R., Jalan, R. Albumin dialysis and molecular adsorbents recirculating system (MARS) for acute Wilson s disease (case report). Liver Transplant. 2002 8 962—967... 

Stange J, Hassanein TI, Mehta R, et al. The molecular adsorbents recycling system as a liver support system based on albumin dialysis a summary of preclinical investigations, prospective, randomized,... 

Carbamazepine-protein binding Bovine serum albumin Dialysis (for sampling) Fluorimetry 6 x 10-6 mol L 1 Flow injection system in vitro study of the binding mechanism of the analyte with albumin mini-column of Pb02(s) for oxidising the analyte to a fluorescent product [528]... 

Pichon N, Dugard A, Clavel M, Amiel JB, Francois B, Vignon P. Extracorporeal albumin dialysis in three cases of acute calcium charmel blocker poisoning with life-threatening refractory. Ann Emerg Med 2012 59 540-4. 

Vanholder et al. (2001) reported increases of protein-bound toxins in dialysis patients and their biological impact. Albumin is the principal protein present in blood and is a caniCT for a number of solutes that are poorly soluble in free solution. So-called albumin dialysis is a process in which blood is dialyzed against an albumin solution that itself undergoes purification by another method (such as adsorption). 

Hassanein TI, Tofteng F, Brown RS, Jr. et al. Randomized controlled study of extracorporeal albumin dialysis for hepatic encephalopathy in advanced cirrhosis. Hepatology 2007 46 1853-62. 

Krisper P, Haditsch B, Stauber R et al. In vivo quantification of hver dialysis Comparison of albumin dialysis and fractionated plasma separation. / Hepatol 2005 43 451-7. 

The cross-linking method relies on bifimctional reagents to form intermolecular linkages between the enzyme molecules to render them insoluble. Often albumin is added as an extender and glutaraldehyde is most commonly employed. This material can then be either formed as a free standing membrane or applied to the inner surface of the dialysis membrane... 

Initiation of dialysis is dependent on the patient s clinical status. Symptoms that may indicate the need for dialysis include persistent anorexia, nausea, vomiting, fatigue, and pruritus. Other criteria that indicate the need for dialysis include declining nutritional status, declining serum albumin levels, uncontrolled hypertension, and volume overload, which may manifest as chronic heart failure, and electrolyte abnormalities, particularly hyperkalemia. Blood urea nitrogen (BUN) and serum creatinine (SCr) levels may be used as a... 

The chilled azide solution is added slowly, dropwise with constant vigorous stirring into a solution of bovine-serum albumin. The pH is maintained at 8.0 to 8.7 by the careful addition of NaOH solution. The resulting pale-yellow solution is kept at 4°C for a duration of 36 hours and then dialysed against trimethamine buffer. After further dialysis for two days against distilled water, the immunogen is isolated by lyophilization. 

The Ki for HSA binding to racemic warfarin has been reported for 3-6 pM by various techniques, including frontal analysis and equilibrium dialysis, and is temperature- and pH-dependent. See Loun, B., Hage, D.S. Chiral separation mechanisms in protein-based HPLC columns. 1. Thermodynamic studies of (R)- and (S)-warfarin binding to immobilized human serum albumin. Anal. Chem. 1994, 66, 3814-3822. 

AES is used in pharmacopoeial assays of (1) Na in albumin solution and plasma protein solution (2) K, Na and barium (Ba) in calcium acetate used to prepare dialysis solutions (3) Ca in adsorbed vaccines (e.g. diphtheria and tetanus). 

Table 29.1 contains examples of weakly, moderately and strongly bound uremic toxins, permeation of which through a dialysis membrane is hindered due to the size of albumin molecules associated with them. Although these toxins are small molecules, their complexes with HSA (MW 67,000 kD) are significantly larger and cannot diffuse through the membrane. 

Serum albumin is a natural transporter of hydrophobic metabolites it binds toxic ligands reversibly, and if the ligand can be removed from the complex then the melting curve of unloaded albumin should return to that of pure protein. However this remains a difficult task, and neither exhaustive dialysis, nor the use of conventional carbonic sorbents, influence the shape of melting curves of albumin isolated from blood plasma of uremic patients and patients with hepatic insufficiency (Fig. 29.3) [9]. 

Allergic reactions to ESAs have been infrequent. There have been a small number of cases of pure red cell aplasia (PRCA) accompanied by neutralizing antibodies to erythropoietin. PRCA was most commonly seen in dialysis patients treated subcutaneously for a long period with a particular form of epoetin alfa (Eprex with a polysorbate 80 stabilizer rather than human serum albumin) that is not available in the USA. After regulatory agencies required that Eprex be administered intravenously rather than subcutaneously, the rate of ESA-associated PRCA diminished. However, rare cases have still been seen with all ESAs administered subcutaneously for long periods to patients with chronic kidney disease. 

Operationally, dialysis (cf. Section 8.2) utilizes differences in the diffusion rates of various substances across a membrane between two liquid phases. The diffusivities of substances in the membrane and liquid phases (particularly the former) decrease with increasing molecular sizes of the diffusing substances. Thus, with any hemodialyzer, the rates of removal of uremic toxins from the blood will decrease with increasing molecular size, although sharp separation at a particular molecular weight is difficult. In contrast, proteins (e.g., albumin) should be retained in the patient s blood. In the human kidney, small amounts of albumin present in the glomerular filtrate are reabsorbed in the proximal tubule. 

DIALYSIS. The process of separating compounds or materials by the difference in their rates of diffusion through a colloidal sentipermeahle membrane. Thus, sodium chloride diffuses eleven limes as last as tannin ami twemy-une times as fast as albumin. When the process is conducted under the influence of a difference in electrical potential, as from electrodes on opposite sides of the semipermeable membrane, it is called clectrodialysis. 

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