ArticlePloS one2016
Protein-Bound Uremic Toxin Profiling as a Tool to Optimize Hemodialysis.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
24 citing papers in PubMed.
- Uremic toxins levels from the gut microbiota seem not to be altered by physical exercise in hemodialysis patients.International urology and nephrology · 2022Trial
- Trial
- Review
- An In Vitro System for Studying Toxin Transport Across Hemodialysis Membranes.Artificial organs · 2026Article
- Transporter-Mediated Interactions Between Uremic Toxins and Drugs: A Hidden Driver of Toxicity in Chronic Kidney Disease.International journal of molecular sciences · 2025Review
- How dialysis frequency and duration impact uremic toxin and fluid removal: a pediatric perspective.Pediatric nephrology (Berlin, Germany) · 2025Review
- Klotho antiaging protein: molecular mechanisms and therapeutic potential in diseases.Molecular biomedicine · 2025Review
- Plasma Metabolite Profiles Between In-Center Daytime Extended-Hours and Conventional Hemodialysis.Kidney360 · 2025Article
- Indoxyl Sulfate Contributes to Impaired Height Velocity in (Pre)School Children.Kidney international reports · 2024Article
- Liquid Chromatography-Mass Spectrometry Analytical Methods for the Quantitation ofPharmaceutics · 2024Review
- Effects of the uremic toxin indoxyl sulphate on human microvascular endothelial cells.Journal of applied toxicology : JAT · 2022Article
- Research progress on the relationship between IS and kidney disease and its complications.International urology and nephrology · 2022Review
- Role and Mechanism of the Renin-Angiotensin-Aldosterone System in the Onset and Development of Cardiorenal Syndrome.Journal of the renin-angiotensin-aldosterone system : JRAAS · 2022Review
- Determinants of Hemodialysis Performance: Modeling Fluid and Solute Transport in Hollow-Fiber Dialyzers.Regenerative engineering and translational medicine · 2021Article
- Uraemic solutes as therapeutic targets in CKD-associated cardiovascular disease.Nature reviews. Nephrology · 2021Review
- Article
- Article
- Uremic Toxin Concentrations are Related to Residual Kidney Function in the Pediatric Hemodialysis Population.Toxins · 2019Article
- In silico comparison of protein-bound uremic toxin removal by hemodialysis, hemodiafiltration, membrane adsorption, and binding competition.Scientific reports · 2019Article
- Review
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimWe studied various hemodialysis strategies for the removal of protein-bound solutes, which are associated with cardiovascular damage.
methodsThis study included 10 patients on standard (3 x 4 h/week) high-flux hemodialysis. Blood was collected at the dialyzer inlet and outlet at several time points during a midweek session. Total and free concentration of several protein-bound solutes was determined as well as urea concentration. Per solute, a two-compartment kinetic model was fitted to the measured concentrations, estimating plasmatic volume (V1), total distribution volume (V tot) and intercompartment clearance (K21). This calibrated model was then used to calculate which hemodialysis strategy offers optimal removal. Our own in vivo data, with the strategy variables entered into the mathematical simulations, was then validated against independent data from two other clinical studies.
resultsDialyzer clearance K, V1 and V tot correlated inversely with percentage of protein binding. All Ks were different from each other. Of all protein-bound solutes, K21 was 2.7-5.3 times lower than that of urea. Longer and/or more frequent dialysis that processed the same amount of blood per week as standard 3 x 4 h dialysis at 300 mL/min blood flow showed no difference in removal of strongly bound solutes. However, longer and/or more frequent dialysis strategies that processed more blood per week than standard dialysis were markedly more adequate. These conclusions were successfully validated.
conclusionWhen blood and dialysate flow per unit of time and type of hemodialyzer are kept the same, increasing the amount of processed blood per week by increasing frequency and/or duration of the sessions distinctly increases removal.
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