Removal characteristics of presepsin by operating conditions and hemofilter.

IF 1.1 4区医学 Q4 ENGINEERING, BIOMEDICAL

Journal of Artificial Organs Pub Date : 2024-09-01 Epub Date: 2023-12-05 DOI:10.1007/s10047-023-01424-w

Tatsumi Yamasaki, Yasuto Miyamoto, Takayuki Goto, Yuuichi Oda, Takeshi Yano, Masahiko Taniguchi, Tetsuro Shirasaka

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Abstract

Presepsin, which is used as a biomarker for sepsis, is thought to be removed by dialysis, but the actual removal properties of dialysis are unknown. We investigated the presepsin removal properties of continuous hemodiafiltration using the high concentration of presepsin from human plasma drained by plasma exchange. Each solution in plasma exchange was connected to a continuous hemodiafiltration blood circuit and circulated at 4 conditions. The results show that presepsin was confirmed to be removed more efficiently in hemofiltration than in hemodialysis. In addition, when using a polymethylmethacrylate hemofilter for continuous hemodiafiltration, the lowest presepsin concentration is on the filtrate side, suggesting that the main removal mechanism is adsorption. Since presepsin has a molecular weight of 13,000, its removal efficiency is high by hemofiltration as per principle. In addition, since the main adsorption principle of polymethylmethacrylate hemofilter is hydrophobic bond, presepsin is considered to be adsorbed. Since presepsin is metabolized in the kidney, it is elevated in renal failure. In this paper, we confirmed that presepsin is eliminated by continuous hemodiafiltration not only in the kidney. Depending on the timing of presepsin measurement, there is a risk of missing the diagnosis of sepsis. Kidney function and continuous hemodiafiltration should be checked when measuring presepsin.

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操作条件和血液过滤器对前胰蛋白酶的去除特性。

人们认为透析可以去除作为败血症生物标志物的前胃蛋白酶，但透析的实际去除特性尚不清楚。我们利用血浆置换排出的高浓度人血浆中的前肝素，研究了连续血液透析去除前肝素的特性。血浆置换中的每种溶液都与连续血液透析血液回路相连，并在 4 种条件下循环。结果表明，血液过滤比血液透析更有效地去除前体蛋白酶。此外，在使用聚甲基丙烯酸甲酯血液滤器进行连续血液透析过滤时，滤液一侧的前体蛋白浓度最低，这表明主要的去除机制是吸附。由于前体蛋白的分子量为 13 000，按照原理，血液过滤对其的去除效率很高。此外，由于聚甲基丙烯酸甲酯血液过滤器的主要吸附原理是疏水键，因此可以认为前体蛋白被吸附。由于前血蛋白在肾脏中代谢，因此在肾功能衰竭时会升高。在本文中，我们证实连续性血液渗滤不仅能消除肾脏中的前体蛋白。根据前体蛋白测量的时间，有可能漏诊败血症。在测量前胰蛋白酶时应检查肾功能和连续性血液滤过。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Artificial Organs 医学-工程：生物医学

CiteScore

2.80

自引率

15.40%

发文量

审稿时长

6-12 weeks

期刊介绍： The aim of the Journal of Artificial Organs is to introduce to colleagues worldwide a broad spectrum of important new achievements in the field of artificial organs, ranging from fundamental research to clinical applications. The scope of the Journal of Artificial Organs encompasses but is not restricted to blood purification, cardiovascular intervention, biomaterials, and artificial metabolic organs. Additionally, the journal will cover technical and industrial innovations. Membership in the Japanese Society for Artificial Organs is not a prerequisite for submission.