Efficacy of HA130 Hemoadsorption in Removing Advanced Glycation End Products in Maintenance Hemodialysis Patients.

IF 2.2 3区医学 Q3 ENGINEERING, BIOMEDICAL

Artificial organs Pub Date : 2025-01-21 DOI:10.1111/aor.14954

Gonzalo Ramírez-Guerrero, Thiago Reis, Barbara Segovia-Hernández, Francisca Aranda, Constanza Verdugo, Cristian Pedreros-Rosales, Matteo Marcello, Janina León, Armando Rojas, Francesco Galli, Claudio Ronco

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引用次数: 0

Abstract

Background: Patients on maintenance hemodialysis (HD) face complications due to the accumulation of protein-bound uremic toxins, such as advanced glycation end products (AGEs), which contribute to inflammation, oxidative stress, and cardiovascular disease. Conventional HD techniques inadequately remove AGEs. This study evaluates the efficacy of the HA130 hemoadsorption cartridge combined with high-flux HD (HF-HD) in enhancing AGE removal.

Methods: This prospective, single-center study included 20 maintenance HD patients randomized into two groups: HF-HD alone (n = 10) and HF-HD plus hemoadsorption (n = 10). Blood samples were collected before and after a single session to measure carboxymethyllysine (CML), soluble RAGE (sRAGE), prolactin, and parathyroid hormone (PTH) levels. Reduction ratios (RR) were calculated, including corrected for hemoconcentration (RRc), to ensure accuracy. Statistical analyses included Mann-Whitney U and Chi-square tests.

Results: The HF-HD plus hemoadsorption group showed significantly enhanced removal of CML compared to HF-HD alone, with RRc of 64.7% [52.6-74.9] versus 39.3% [33.8-49.4], respectively (p = 0.045). Similarly, uncorrected reduction ratios demonstrated a trend favoring hemoadsorption, with values of 57.5% [45.1-70.7] versus 30.3% [19.1-44.5] (p = 0.053). Importantly, sRAGE levels were preserved in both groups (RRc: 23.4% (15.1-30.4) vs. 21.8% (16.6-31.7), p = 0.791), highlighting the safety of hemoadsorption. Other biochemical parameters, including prolactin, PTH, albumin, and electrolytes, showed no significant differences between groups. All sessions were completed without adverse events.

Conclusion: Combining hemoadsorption with HF-HD significantly enhances CML removal, as evidenced by corrected RR, without compromising protective sRAGE levels. This innovative approach offers a promising adjunctive therapy for reducing AGEs-related complications in end-stage renal disease patients. Further longitudinal studies are needed to confirm these findings and evaluate long-term outcomes.

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HA130血液吸附去除维持性血液透析患者晚期糖基化终产物的疗效。

背景：维持性血液透析（HD）患者由于蛋白结合尿毒症毒素的积累而面临并发症，如晚期糖基化终产物（AGEs），这有助于炎症、氧化应激和心血管疾病。传统的高清技术不能充分去除AGEs。本研究评估了HA130血液吸附盒联合高通量HD （HF-HD）增强AGE去除的效果。方法：本前瞻性单中心研究纳入20例维持性HD患者，随机分为两组：单独使用HF-HD （n = 10）和HF-HD联合血液吸附（n = 10）。在单次治疗前后采集血液样本，测量羧甲基赖氨酸（CML）、可溶性RAGE （sRAGE）、催乳素和甲状旁腺激素（PTH）水平。计算还原比（RR），包括校正血液浓度（RRc），以确保准确性。统计分析采用Mann-Whitney U检验和卡方检验。结果：与单独使用HF-HD相比，HF-HD联合血液吸附组CML去除率显著提高，RRc分别为64.7%[52.6-74.9]和39.3% [33.8-49.4]（p = 0.045）。同样，未校正的还原比率显示出有利于血液吸附的趋势，值为57.5%[45.1-70.7]对30.3% [19.1-44.5]（p = 0.053）。重要的是，两组的sRAGE水平均保持不变(RRc: 23.4% (15.1-30.4) vs. 21.8% (16.6-31.7), p = 0.791)，强调了血液吸附的安全性。其他生化参数，包括催乳素、甲状旁腺素、白蛋白和电解质，组间无显著差异。所有疗程均无不良事件发生。结论：血液吸附联合HF-HD可显著增强CML清除，校正后的RR证明了这一点，而不影响保护性sRAGE水平。这种创新的方法为减少终末期肾脏疾病患者的年龄相关并发症提供了一种有希望的辅助治疗方法。需要进一步的纵向研究来证实这些发现并评估长期结果。

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

Artificial organs 工程技术-工程：生物医学

CiteScore

4.30

自引率

12.50%

发文量

303

审稿时长

4-8 weeks

期刊介绍： Artificial Organs is the official peer reviewed journal of The International Federation for Artificial Organs (Members of the Federation are: The American Society for Artificial Internal Organs, The European Society for Artificial Organs, and The Japanese Society for Artificial Organs), The International Faculty for Artificial Organs, the International Society for Rotary Blood Pumps, The International Society for Pediatric Mechanical Cardiopulmonary Support, and the Vienna International Workshop on Functional Electrical Stimulation. Artificial Organs publishes original research articles dealing with developments in artificial organs applications and treatment modalities and their clinical applications worldwide. Membership in the Societies listed above is not a prerequisite for publication. Articles are published without charge to the author except for color figures and excess page charges as noted.