A STUDY ON THE METHODS FOR THE REMOVAL OF PROTEIN-BOUND COMPOUNDS ACCUMULATED IN SERUM OF PATIENTS ON MAINTENANCE HEMODIALYSIS: COMPARISON OF HEMODIALYSIS AND ORAL SORBENT.

Abstract

Protein (albumin)-bound indoxyl sulfate and 3-carboxy-4-methyl-5-propyl-2-furanpropionic acid (CMPF) are markedly accumulated in serum of patients on maintenance hemodialyis (HD). Since the protein-bound compounds cannot be removed by conventional hemodialysis, we studied on the methods for the removal by HD with high-performance membrane dialyzers and/or by oral sorbent AST-120. CMPF could not be removed even by high-performance HD. Further, its serum concentration did not decrease after oral intake of oral sorbent. Reduction rates of indoxyl sulfate by HD with high-performance dialyzers such as FB-150U and PE-1.25UD were higher than those by HD with conventional dialyzers, but their reduction rates were not sufficient to decrease its serum concentrations. Supplementary use of oral sorbent AST-120 was effective to decrease markedly the serum concentrations of indoxyl sulfate in the HD patients.