Organic Acids And Other Metabolites In Renal Failure And Their Removal With Blood Purification Procedures
Regular Dialysis Treatment (RDT) has achieved dramatic clinical results over the past 20 years, but the RDT patient’s condition remains unsatisfactory when compared with that of a healthy person. The failure of RDT to replicate the renal endocrine function or the secretory excretion function of the renal tubule cells, together with the intermittent nature (2–3 times per week) of the treatment, are considered to be among the reasons. For example, the 5-hour RDT treatments given thrice weekly provide a mean creatinine clearance of 15 ml/min, which is much less than in the living kidney. Moreover, clearance of organic acids, which are normally excreted by the secretory function of the renal tubule cells is thought to be lower than the clearance of creatinine, because most organic acids bind to protein in plasma (Bultitude and Newham, 1975; Dowty et al., 1975; Masimore et al., 1977). To verify this, the present investigators have analysed and quantified the serum organic acids in long-term RDT patients and compared them with those of the normal subject. Also reported here is the evaluation of the organic acid adsorptive capacity of haemoperfusion-type cellulose-microencapsulated activated charcoal (TC-10 TEIJIN, Tokyo) using RDT patient ultrafiltrate. The effectiveness of haemoperfusion with microencapsulated charcoal as a replacement method of urinary tubule secretory excretion function is estimated.
KeywordsActivate Charcoal Vanillic Acid Azelaic Acid Organic Acid Concentration Pimelic Acid
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