Safety Of Electro-Oxidation For Urea Removal In A Wearable Artificial Kidney Is Compromised By Formation Of Glucose Degradation Products
van Gelder, Maaike K; Vollenbroek, Jeroen C; Lentferink, Babette H; Hazenbrink, Diënty H M; Besseling, Paul J; Simonis, Frank; Giovanella, Silvia; Ligabue, Giulia; Bajo Rubio, Maria A; Cappelli, Gianni; Joles, Jaap A; Verhaar, Marianne C; Gerritsen, Karin G F
(2021) Artificial Organs, volume 45, issue 11, pp. 1422 - 1428
(Article)
Abstract
A major challenge for the development of a wearable artificial kidney (WAK) is the removal of urea from the spent dialysate, as urea is the waste solute with the highest daily molar production and is difficult to adsorb. Here we present results on glucose degradation products (GDPs) formed during electrooxidation
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(EO), a technique that applies a current to the dialysate to convert urea into nitrogen, carbon dioxide, and hydrogen gas. Uremic plasma and peritoneal effluent were dialyzed for 8 hours with a WAK with and without EO-based dialysate regeneration. Samples were taken regularly during treatment. GDPs (glyoxal, methylglyoxal, and 3-deoxyglucosone) were measured in EO- and non-EO-treated fluids. Glyoxal and methylglyoxal concentrations increased 26- and 11-fold, respectively, in uremic plasma (at [glucose] 7 mmol/L) and 209- and 353-fold, respectively, in peritoneal effluent (at [glucose] 100 mmol/L) during treatment with EO, whereas no change was observed in GDP concentrations during dialysate regeneration without EO. EO for dialysate regeneration in a WAK is currently not safe due to the generation of GDPs which are not biocompatible.
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Keywords: 3-Deoxyglucosone, artificial kidney, biocompatibility, electrooxidation, glucose degradation products, glyoxal, hemodialysis, methylglyoxal, peritoneal dialysis, urea, Bioengineering, Biomedical Engineering, Medicine (miscellaneous), Biomaterials, Journal Article
ISSN: 0160-564X
Publisher: Wiley-Blackwell
Note: Funding Information: We gratefully thank Prof. CG Schalkwijk and Drs. MPH van de Waarenburg (Department of Internal Medicine, MUMC, Maastricht, the Netherlands) for the measurement of GDPs. This study was supported by the European Union (WEAKID, Horizon 2020 Research and Innovation Program, grant agreement no. 733169) and by the Dutch Kidney Foundation (grant no. NT12.05). Funding Information: We gratefully thank Prof. CG Schalkwijk and Drs. MPH van de Waarenburg (Department of Internal Medicine, MUMC, Maastricht, the Netherlands) for the measurement of GDPs. This study was supported by the European Union (WEAKID, Horizon 2020 Research and Innovation Program, grant agreement no. 733169) and by the Dutch Kidney Foundation (grant no. NT12.05). All authors acknowledge the financial support of the Strategic Alliance of the University of Twente,University of Utrecht and University Medical Center Utrecht. Publisher Copyright: © 2021 The Authors. Artificial Organs published by International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC.
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