Abstract
The removal of uremic solutes from dialysate by chemical compounds with adsorptive capacity provides a methodology for achieving a major reduction in the volume of dialysate necessary for conducting effective dialysis. Sorbent regeneration of dialysate permits a system with a small volume of recirculating dialysate to maintain maximal blood to dialysate concentration gradients and to potentially achieve mass transfer efficiency equal to that of a large volume recirculating or single pass dialysate flow system. Activated carbon, by virtue of its ability to adsorb organic nitrogenous compounds has served as the basic component of virtually all sorbent systems applied to the treatment of uremia. Yatzidis(1) demonstrated that activated carbon could adsorb creatinine, uric acid, phenols, indolic compounds, guanidines and organic acids. The adsorption of endogenous uremic metabolites of middle molecular weight configuration has also been demonstrated and there is presumptive clinical evidence derived from patients treated with sorbent systems that activated carbon probably adsorbs all organic uremic metabolites, known or as yet unidentified, which are of toxic significance(2–4). Unfortunately, there is one exception to this remarkable affinity of carbon for nitrogenous uremic metabolites.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Bibliography
Yatzidis, H. A convenient hemoperfusion microapparatus over charcoal for the treatment of endogenous and exogenous intoxication. Its use as an effective artificial kidney. Proc Eur Dial Transpl Assoc 1, 83, 1964
Chang, T.M.S., Migchelsen, M., Coffey, J.F. and Stark, R. Serum middle molecule levels in uremia during long-term intermittent hemoperfusîon with the ACAC (coated charcoal) microcapsule artificial kidney, Trans, Amer Soc Artif Int Organs 20-A, 364, 1974
Gordon, A., Lewin, A., Rosenfeld, J., et al. Adsorption of uremic toxins. Proc. 6th Int. Congr. Nephrol., Florence, 1975, pp. 612–7, (Karger, Basel, 1976)
Yatzidis, H., Psimenos, G. and Mayopoulou-Symvolidis, D. Nondialysable toxic factor in uremic blood effectively removed by the activated charcoal. Experientia 25, 1144, 1969
Sparks, R.E., Blaney, J.L. and Lindan, O. Adsorption of nitrogenous waste metabolites from artificial kidney dialyzing fluids. Chem Engr Prog Symp Series 62, 2, 1966
Blaney, J.L., Lindan, O. and Sparks, R.E. Adsorption — a step toward a wearable artificial kidney. Trans Amer Soc Artif Int Organs 12, 7, 1966
Kolobow, J. and Dedrick, R.L. Dialysate capacity augmentation at ultra-low flow rates with activated carbon slurry. Trans Amer Soc Artif Int Organs 12, 1, 1966
Twiss, E.E. and Paulssen, M.M.P. Dialysis system incorporating the use of activated charcoal. Proc Eur Dial Transpl Assoc 3, 262, 1966
Jutzler, G.A., Keller, H.E., Klein, J., et al. Physico-chemical investigations in regeneration of dialyzing fluid Proc Eur Dial Transpl Assoc 2, 265, 1966
Maeda, K., Ohta, K., Manji, T., et al. Dialysate regeneration: 30 liter dialysate supply system with sorbents. Kidney Int 10 (Suppl.7), S-289, 1976
Malchesky, P.S., Surovy, R.M. and Nosé, Y. The charcoal coil: A dialysis-dialysate regeneration system. Kidney Int 10 (Suppl. 7), S-296, 1976
Kolff, W.J., Jacobsen, S., Stephen, R.L. and Rose, D. Towards a wearable artificial kidney. Kidney Int 10, (Suppl.7), S-300, 1976
Giordano, C., Esposito, R. and Bello, P. A cold charcoal depurator for the adsorption of high quantities of urea. Kidney Int 10 (Suppl.7), S-284, 1976
Giordano, C., Esposito, R., Pluvio, M. and Gonzalez, F. Oxycelluloses: A group of sorbents to remove extracorporeal urea. Kidney Int (Suppl.7), S-348, 1976
Hydén, H. Compact low volume self-regenerating artificial kidney. Presented at 10th Annual Contractor’s Conf. NIAMDD. Jan. 17–19, 1977, Bethesda, Md.
Gordon, A., Lewin, A., Marantz, L.B. and Maxwell, M.H. Sorbent regeneration of dîalysate. Kidney Int 10, (Suppl.7) S-277, 1976
Christopher, T.G., Cambi, V., Harker, L.A., et al. A study of hemodialysis with lowered dialysate flow rate. Trans Amer Soc Artif Int Organs 17, 92, 1971
Wathen, R.L., Shapiro, F.L., Comty, C.M. and Keshaviah, P. Low flow dialysate study. Presented at 10th Annual Contractor’s Conf. NIAMDD, Jan. 17–19, 1977, Bethesda, Md.
Gentile, D. Use of bicarbonate in dialysate of the sorbent delivery system. Abstract submitted to Amer. Soc. Artif. Int. Organs, 1977
Raja, R.M., Kramer, M.S. and Rosenbaum, J.L. Recirculation peritoneal dialysis with sorbent REDY cartridge. Nephron 16, 134, 1976
Gordon, A., Lewin, A.J., Maxwell, M.H. and Morales, N.D. Augmentation of efficiency by continuous flow sorbent regeneration peritoneal dialysis. Trans Amer Soc Artîf Int Organs 22, 599, 1976
Stephen, R.L., Atkin-Thor, E. and Kolff, W.J. Recirculating peritoneal dialysis with subcutaneous catheter. Trans Amer Soc Artif Int Organs 22, 575, 1976
Popovich, R.P., Moncrief, J.W., Decherd, J.F., et al. Clinical development of the low dialyses clearance hypothesis via equilibrium peritoneal dialyses. Presented at 10th Annual Contractor’s Conf., NIAMDD. Jan. 17–19, 1977, Bethesda, Md.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1978 Plenum Press, New York
About this chapter
Cite this chapter
Gordon, A., Lewin, A.J., Maxwell, M.H., Roberts, M. (1978). Current Status of Dialysate Regeneration for the Treatment of Chronic Uremia. In: Chang, T.M.S. (eds) Artificial Kidney, Artificial Liver, and Artificial Cells. Springer, Boston, MA. https://doi.org/10.1007/978-1-4684-2478-2_4
Download citation
DOI: https://doi.org/10.1007/978-1-4684-2478-2_4
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4684-2480-5
Online ISBN: 978-1-4684-2478-2
eBook Packages: Springer Book Archive