American Journal of Kidney Diseases
Volume 54, Issue 1 , Pages 104-111, July 2009

β2-Microglobulin and Phosphate Clearances Using a Wearable Artificial Kidney: A Pilot Study

  • Victor Gura, MD

      Affiliations

    • Cedars Sinai Medical Center, UCLA, The David Geffen School of Medicine, Los Angeles, CA
    • Xcorporeal Inc, Los Angeles, CA
    • Corresponding Author InformationAddress correspondence to Victor Gura, MD, Associate Clinical Professor of Medicine. UCLA, The Geffen School of Medicine, 9100 Wilshire Blvd, Ste 360W, Beverly Hills, CA 90212
    • ,
  • Andrew Davenport, MD

      Affiliations

    • Center for Nephrology, Division of Medicine, Royal Free and University College Hospital Medical School, London, UK
    • ,
  • Masoud Beizai, PhD

      Affiliations

    • Xcorporeal Inc, Los Angeles, CA
    • ,
  • Carlos Ezon, MD

      Affiliations

    • Xcorporeal Inc, Los Angeles, CA
    • ,
  • Claudio Ronco, MD

      Affiliations

    • Divisione de Nefrologia, Ospedale San Bortolo, Vicenza, Italy

Received 14 November 2008; accepted 4 February 2009. published online 20 April 2009.

Background

Additional small-solute clearances during standard thrice-weekly hemodialysis treatments have not improved patient survival. However, these treatments have limited middle-molecule clearances. Thus, newer therapies designed to increase middle-molecule clearances need to be developed and evaluated.

Study Design

Pilot clinical trial to measure β2-microglobulin and phosphate clearances with a wearable hemodialysis device.

Setting & Participants

8 regular hemodialysis patients under the care of a university teaching hospital.

Intervention

Patients were fitted with a wearable hemodialysis device for 4 to 8 hours.

Outcomes

All patients tolerated the treatment.

Results

Average amount of β2-microglobulin removed was 99.8 ± 63.1 mg, with mean clearance of 11.3 ± 2.3 mL/min, and an average of 445.2 ± 326 mg of phosphate was removed, with mean plasma phosphate clearance of 21.7 ± 4.5 mL/min. These clearances compared favorably with mean urea and creatinine plasma clearances (21.8 ± 1.6 and 20.0 ± 0.8 mL/min, respectively).

Limitations

Proof-of-concept preliminary trial. Additional studies are warranted to confirm these positive preliminary data.

Conclusions

This wearable artificial kidney potentially provides effective β2-microglobulin and phosphate clearances and, by analogy, middle-molecule clearances.

Index Words: Chronic kidney disease, hemodialysis, wearable artificial kidney, phosphate, β2-microglobulin, clearances

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 Originally published online as doi: 10.1053/j.ajkd.2009.02.006 on April 20, 2009.

 Trial registration: ClinicalTrials.gov; study number: NCT00454974.

PII: S0272-6386(09)00433-8

doi:10.1053/j.ajkd.2009.02.006

American Journal of Kidney Diseases
Volume 54, Issue 1 , Pages 104-111, July 2009

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