Blood Purification最新文献

{"title":"Considerations of Implementation Science in Resource-Limited Settings.","authors":"Rolando Claure-Del Granado, Thiago Reis, Aarthi Vijaykumar, Etienne Macedo, Nattachai Srisawat, Oleksa Gregory Rewa, Javier A Neyra, Jeremiah Brown, Marlies Ostermann, Ravi Mehta, Claudio Ronco","doi":"10.1159/000553141","DOIUrl":"10.1159/000553141","url":null,"abstract":"","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-15"},"PeriodicalIF":2.2,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148720952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspective: The Future of Peritoneal Dialysis in the Era of Telemedicine and Artificial Intelligence.","authors":"Paolo Lentini, Kianoush Kashani, Claudio Ronco","doi":"10.1159/bpu/abpag005","DOIUrl":"10.1159/bpu/abpag005","url":null,"abstract":"","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Comment beyond Biochemical Control: Reconsidering the Skeletal Impact of Calcimimetics in Hemodialysis.","authors":"Mario Cozzolino, Paola Ciceri, Lorenza Magagnoli","doi":"10.1159/bpu/abpag004","DOIUrl":"10.1159/bpu/abpag004","url":null,"abstract":"","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Possible Clinical Effects of Polymyxin B-Immobilized Fiber Columns via Platelet-Derived Lipid Mediators: A Prospective Observational Study.","authors":"Shintaro Suzuki, Satoshi Kazuma, Hiroomi Tatsumi, Yoshiki Masuda, Yoko Koga, Hiroyuki Meguro, Mie Kaino, Masakazu Shinohara","doi":"10.1159/000553006","DOIUrl":"10.1159/000553006","url":null,"abstract":"<p><strong>Introduction: </strong>Endotoxin removal therapy using a polymyxin B-immobilized fiber column (PMX) has been reported to improve hemodynamics in patients with septic shock. However, the mechanisms underlying the blood pressure-increasing effects of PMX treatment remain unclear, and factors other than endotoxin adsorption may be involved. This study focused on vasoconstrictive lipid mediators in the blood and comprehensively analyzed these mediators in patients with septic shock.</p><p><strong>Methods: </strong>This prospective observational study included 10 patients with septic shock who underwent PMX treatment. Blood samples were collected at multiple time points up to 120 min after PMX initiation, and 23 lipid mediators were measured by mass spectrometry. Hemodynamic changes were evaluated using the vasopressor dependency index (VDI). Furthermore, platelet-rich plasma from healthy subjects was incubated with PMX fibers in vitro to assess platelet adhesion by electron microscopy and thromboxane production.</p><p><strong>Results: </strong>Among the 10 patients included, the plasma concentration of thromboxane B₂ (TXB₂), a stable derivative of thromboxane A₂ (TXA₂), was significantly higher at the PMX column outlet than at the inlet. This difference in TXB₂ concentration showed a significant positive correlation with platelet count. Patients with higher platelet counts tended to exhibit a greater decrease in VDI, although the difference was not statistically significant. In vitro experiments demonstrated that platelets adhered to PMX fibers, accompanied by morphological changes, and that the fibers stimulated TXB₂ production. Importantly, this production was suppressed by an antibody against the platelet surface antigen αIIbβ3.</p><p><strong>Conclusion: </strong>TXA₂, produced by platelets upon contact with PMX fibers during treatment, may contribute to the rapid increase in blood pressure observed after initiation of therapy.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-10"},"PeriodicalIF":2.2,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum.","authors":"","doi":"10.1159/000552410","DOIUrl":"https://doi.org/10.1159/000552410","url":null,"abstract":"<p><p>In the article \"Extracorporeal Blood Purification with the oXiris® Filter for Patients with Sepsis and Hyperinflammatory Conditions: The Asia-Pacific oXiris Expert Meeting 2024 Consensus Statements\" [Blood Purif. 2025;54(11):621-638; https://doi.org/10.1159/000548214] by Zhang et al., the authors noticed there was an error in Figure 1.Fig. 1.Treatment algorithm for oXiris filter use in patients needing CRRT with sepsis/septic shock, severe COVID-19 or other hyperinflammatory states. AKI, acute kidney injury; APACHE, Acute Physiology and Chronic Health Evaluation; CRP, C-reactive protein; CRRT, continuous renal replacement therapy; CVVH, continuous veno-venous hemofiltration; CVVHD, continuous veno-venous hemodialysis; CVVHDF, continuous veno-venous hemodiafiltration; EAA, endotoxin activity assay; ECMO, extracorporeal membrane oxygenation; HIT, heparin-induced thrombocytopenia; SOFA, Sequential Organ Failure Assessment; KDIGO, Kidney Disease: Improving Global Outcomes; PCT, procalcitonin; IL, interleukin; PaO2/FiO2, partial pressure-to-fractional inspired oxygen ratio; SCUF, slow continuous ultrafiltration; TNF, tumor necrosis factor.In the \"Failure\" column of the \"Evaluate treatment success/failure\" section, the figure originally stated: \"Improvement in hemodynamic parameters/dependence on vasopressors after 72 hours.\" The word \"No\" was inadvertently omitted at the beginning of this criterion. The correct statement should read: \"No improvement in hemodynamic parameters/dependence on vasopressors after 72 hours.\"The error was introduced during the preparation of the figure. The correct wording has been verified by cross-referencing the figure with Statement 5.1 in the main text (p. 630) and Table 1 (p. 625), both of which consistently and correctly state the treatment futility criterion as: \"No improvement in hemodynamic parameters/dependence on vasopressors after 72 hours.\" The corrected Figure 1 is shown below.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-2"},"PeriodicalIF":2.2,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of the Combination Therapy of Hemodialysis with Hemoperfusion on Medium Molecular Toxins and Protein Bound Uremic Toxins in Maintenance Hemodialysis Patients.","authors":"De-Hui Zeng, Jin-Li Ma, Ze-Peng Zou, Xia-Hua Chen, Yun Li, Bai-Li Wang, Xiang-Yang Zhu, Ya-Li Cao","doi":"10.1159/000553494","DOIUrl":"10.1159/000553494","url":null,"abstract":"<p><strong>Introduction: </strong>Protein-bound uremic toxins (PBUTs) and medium molecular toxins are incompletely removed by conventional hemodialysis (HD) and are associated with cardiovascular morbidity and mortality in maintenance hemodialysis (MHD) patients. This study aimed to observe the reduction ratios of the combination therapy of HD with hemoperfusion (HP) on medium molecular toxins and PBUTs in MHD patients.</p><p><strong>Methods: </strong>In this single-center observational study, 38 MHD patients were treated with HD plus HP using the Jafron KHA130 cartridge for 12 weeks. Serum concentrations of β2-microglobulin (β2-MG), indoxyl sulfate (IS), and p-cresyl sulfate (PCS) were measured by enzyme-linked immunosorbent assay (ELISA) at baseline and after 12 weeks, and their reduction rates were calculated. Patients were stratified by the number of HP sessions received during the study period: group A (>4 times/12 weeks, n = 16) and group B (≤4 times/12 weeks, n = 22). The reduction ratio of blood β2-MG and PBUTs (PCS, IS) from baseline were compared between the 2 groups of patients at 12 weeks.</p><p><strong>Results: </strong>After the 12-week study period, significant reductions were observed in serum levels of β2-MG (from 29.72 ± 5.61-21.50 ± 6.69 μg/mL, t = 5.882, p < 0.001; median reduction ratio 30.48%), IS (from 14.04 ± 1.70-11.70 ± 1.12 μg/mL, t = 7.199, p < 0.001; median reduction ratio 14.61%), and PCS (from 8.09 ± 1.58-6.63 ± 1.33 μg/mL, t = 4.984, p < 0.001; median reduction ratio 17.10%). There was no statistically significant difference in the reduction ratio of β2-MG, PCS, and IS between group A and group B (p > 0.05). The treatment was well tolerated, with only 3 episodes of hypotension that resolved with conservative management.</p><p><strong>Conclusion: </strong>Combined HD and HP therapy was associated with lower serum levels of β2-MG, IS, and PCS in MHD patients, suggesting this modality may represent a viable strategy for achieving reductions in PBUT and medium molecular toxin levels. The relationship between HP session frequency and toxin reduction requires further investigation in adequately powered randomized controlled trials.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-11"},"PeriodicalIF":2.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung Ultrasound and VExUS in Kidney Transplant Recipients: Methodological Considerations and Future Directions.","authors":"Abhilash Koratala, Claudio Ronco, Amir Kazory","doi":"10.1159/bpu/abpag003","DOIUrl":"10.1159/bpu/abpag003","url":null,"abstract":"","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148629078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time-Dependent Kinetics and Saturation Dynamics of Interleukin-6 Clearance During Combined HA380 Hemoadsorption and Continuous Renal Replacement Therapy in Sepsis-Associated Acute Kidney Injury.","authors":"Xinyue Ma, Haichao Zhang, Guangting Cong, Yunlong Wang, Huiwen Sun, Jingjing Liang, Yuhang Wang, Wei Yang","doi":"10.1159/bpu/abpag002","DOIUrl":"10.1159/bpu/abpag002","url":null,"abstract":"<p><strong>Background: </strong>The HA380 hemoadsorption cartridge is increasingly used in septic patients receiving continuous renal replacement therapy (CRRT) for cytokine removal. However, its adsorption kinetics and saturation threshold in clinical settings remain unclear.</p><p><strong>Methods: </strong>We conducted a prospective observational study in the intensive care unit of the First Affiliated Hospital of Harbin Medical University from July 2023 to July 2024. Thirty patients with sepsis-associated acute kidney injury (SA-AKI) who required CRRT were enrolled. Blood samples were collected from the inflow and outflow ports of the HA380 cartridge at baseline and every two hours during a 24-hour treatment session. Interleukin-6 (IL-6) concentrations were determined by ELISA, and clearance efficiency was calculated. Key laboratory parameters, including procalcitonin (PCT), C-reactive protein (CRP), and acid-base balance, were compared before and after treatment. Changes in adsorption efficiency over time were analyzed using linear mixed-effects models.</p><p><strong>Results: </strong>IL-6 clearance reached its maximum at 2 hours (90.0%) and progressively decreased by 13.32% compared with baseline at 14 h (p=0.004). PCT and white blood cell counts decreased significantly after therapy (p<0.05), while CRP levels showed no significant change. Blood pH and base excess improved significantly, whereas reductions in serum creatinine and urea nitrogen were not statistically significant.</p><p><strong>Conclusions: </strong>In patients with SA-AKI undergoing CRRT combined with HA380 hemoadsorption, IL-6 removal was most effective within the first 2 hours, the clearance rate shows an increasing trend from 4 to 12 hours and then decreases and declined notably after approximately 12 hours, indicating cartridge saturation. These findings suggest that cartridge replacement within this timeframe may help maintain effective cytokine clearance and support optimal treatment performance.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148629256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protocol for the OxiCLEAR Study: In vivo Saturation and Adsorption Kinetics of the Oxiris Hemofilter in Septic Shock.","authors":"Darja Smirnova, Marcus Ewert Broman, Valdis Liguts, Andrejs Skesters, Gianluca Villa, Olegs Sabelnikovs","doi":"10.1159/bpu/abpag001","DOIUrl":"10.1159/bpu/abpag001","url":null,"abstract":"<p><strong>Introduction: </strong>Extracorporeal blood purification is increasingly used as adjunctive therapy in septic shock to modulate dysregulated host immune responses. The AN69-polyethyleneimine-based Oxiris hemofilter combines renal replacement therapy with nonselective adsorption of endotoxin and inflammatory mediators. Despite its widespread clinical use and reported biological and hemodynamic effects, the in vivo adsorption capacity, saturation kinetics, and duration of effective solute removal during routine clinical application remain insufficiently characterized.</p><p><strong>Methods: </strong>This is a prospective, single-center observational cohort study enrolling 29 adult patients with septic shock and sepsis-associated acute kidney injury undergoing continuous veno-venous hemofiltration with the Oxiris hemofilter as part of standard care. Both blood samples (from the inlet and outlet of the extracorporeal circuit) and effluent samples will be collected at predefined time points within the first 24 h of treatment. Endotoxin concentrations will be measured using a high-sensitivity competitive enzyme-linked immunosorbent assay, and inflammatory mediators will be quantified using multiplex immunoassays. The primary analysis will evaluate the dynamic adsorption capacity and saturation behavior of the Oxiris membrane for endotoxin and inflammatory mediators by analyzing the relationship between inlet concentrations and adsorption rates over time using Pearson correlation coefficients with Fisher's Z-transformation. Secondary outcomes include changes in hemodynamics, lactate, inflammatory biomarkers, renal recovery, intensive care unit length of stay, and 28-day mortality.</p><p><strong>Conclusion: </strong>This study aimed to provide systematic in vivo characterization of adsorption kinetics, clearance mechanisms, and saturation dynamics of the Oxiris hemofilter in septic shock. The findings are expected to support more rational filter replacement strategies and individualized treatment timing, thereby enabling a more targeted and evidence-based application of the Oxiris therapy in critically ill patients.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of High-Flux Hemodialysis Combined with KHA130 Hemoadsorption versus HA130 Hemoadsorption or Hemodiafiltration for Toxin Clearance.","authors":"Peng Zhang, Liyuan Ma, Rui Hao, Bo Zhao, Wentao Wang, Li Yuan, Xuan Wang, Shudong Zhang","doi":"10.1159/000553597","DOIUrl":"10.1159/000553597","url":null,"abstract":"<p><strong>Introduction: </strong>Effective removal of protein-bound and middle/large molecular toxins is essential in maintenance hemodialysis (HD). This study compared the efficacy of high-flux HD combined with KHA130 hemoadsorption (HA) cartridge against hemodiafiltration (HDF) and high-flux HD combined with the HA130 HA cartridge.</p><p><strong>Methods: </strong>Sixty patients were randomized to HDF group (n = 20), HD+HA group (n = 20), and HD+KHA group (n = 20). HD+HA and HD+KHA groups received 2 h of HA followed by additional 2 h of high-flux HD. The HDF group received 4 h of HDF using the post-dilution mode. The primary endpoint was the single-session clearance rate of the protein-bound toxin p-cresyl sulfate (PCS), with a non-inferiority margin set at 10%. Secondary endpoints included clearance of indoxyl sulfate (IS), advanced glycation end products (AGEs), β2-microglobulin (β2-MG), and inflammatory factors.</p><p><strong>Results: </strong>Baseline characteristics were comparable. For the primary endpoint of PCS clearance, HD+KHA was non-inferior to HDF and superior to HD+HA (p < 0.01). Results for secondary endpoints were less consistent: non-inferiority for IS and β2-MG clearance was observed only in unadjusted models, and no non-inferiority was observed for AGEs or inflammatory cytokines. Sensitivity analyses confirmed the robustness of the primary finding. No serious adverse events were reported.</p><p><strong>Conclusion: </strong>In this acute single-session biochemical study, the HD+KHA regimen met the criterion for non-inferiority to HDF and superiority to HD+HA for PCS clearance. However, given the exploratory nature of secondary and subgroup analyses, these findings require confirmation in larger, adequately powered studies with longer follow-up.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-11"},"PeriodicalIF":2.2,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148560620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}