Interaction of Human Serum Albumin with Uremic Toxins: The Need of New Strategies Aiming at Uremic Toxins Removal
Chronic kidney disease (CKD) is acknowledged worldwide to be a grave threat to public health, with the number of US end-stage kidney disease (ESKD) patients increasing steeply from 10,000 in 1973 to 703,243 in 2015. Protein-bound uremic toxins (PBUTs) are excreted by renal tubular secretion in healt...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-02-01
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| Series: | Membranes |
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| Online Access: | https://www.mdpi.com/2077-0375/12/3/261 |
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| author | Fahimeh Zare Adriana Janeca Seyyed M. Jokar Mónica Faria Maria Clara Gonçalves |
| author_facet | Fahimeh Zare Adriana Janeca Seyyed M. Jokar Mónica Faria Maria Clara Gonçalves |
| author_sort | Fahimeh Zare |
| collection | DOAJ |
| description | Chronic kidney disease (CKD) is acknowledged worldwide to be a grave threat to public health, with the number of US end-stage kidney disease (ESKD) patients increasing steeply from 10,000 in 1973 to 703,243 in 2015. Protein-bound uremic toxins (PBUTs) are excreted by renal tubular secretion in healthy humans, but hardly removed by traditional haemodialysis (HD) in ESKD patients. The accumulation of these toxins is a major contributor to these sufferers’ morbidity and mortality. As a result, some improvements to dialytic removal have been proposed, each with their own upsides and drawbacks. Longer dialysis sessions and hemodiafiltration, though, have not performed especially well, while larger dialyzers, coupled with a higher dialysate flow, proved to have some efficiency in indoxyl sulfate (IS) clearance, but with reduced impact on patients’ quality of life. More efficient in removing PBUTs was fractionated plasma separation and adsorption, but the risk of occlusive thrombosis was worryingly high. A promising technique for the removal of PBUTs is binding competition, which holds great hopes for future HD. This short review starts by presenting the PBUTs chemistry with emphasis on the chemical interactions with the transport protein, human serum albumin (HSA). Recent membrane-based strategies targeting PBUTs removal are also presented, and their efficiency is discussed. |
| first_indexed | 2024-03-09T13:22:23Z |
| format | Article |
| id | doaj.art-71a3400b0eca4f1386462fb80cdb1e57 |
| institution | Directory Open Access Journal |
| issn | 2077-0375 |
| language | English |
| last_indexed | 2024-03-09T13:22:23Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Membranes |
| spelling | doaj.art-71a3400b0eca4f1386462fb80cdb1e572023-11-30T21:27:55ZengMDPI AGMembranes2077-03752022-02-0112326110.3390/membranes12030261Interaction of Human Serum Albumin with Uremic Toxins: The Need of New Strategies Aiming at Uremic Toxins RemovalFahimeh Zare0Adriana Janeca1Seyyed M. Jokar2Mónica Faria3Maria Clara Gonçalves4Departamento de Engenharia Química, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisboa, PortugalCenter of Physics and Engineering of Advanced Materials (CeFEMA), Laboratory for Physics of Materials and Emerging Technologies (LaPMET), Chemical Engineering Department, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisbon, PortugalDepartment of Chemical, Petroleum and Gas Engineering, Shiraz University of Technology, Shiraz 71557-13876, IranCenter of Physics and Engineering of Advanced Materials (CeFEMA), Laboratory for Physics of Materials and Emerging Technologies (LaPMET), Chemical Engineering Department, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisbon, PortugalDepartamento de Engenharia Química, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisboa, PortugalChronic kidney disease (CKD) is acknowledged worldwide to be a grave threat to public health, with the number of US end-stage kidney disease (ESKD) patients increasing steeply from 10,000 in 1973 to 703,243 in 2015. Protein-bound uremic toxins (PBUTs) are excreted by renal tubular secretion in healthy humans, but hardly removed by traditional haemodialysis (HD) in ESKD patients. The accumulation of these toxins is a major contributor to these sufferers’ morbidity and mortality. As a result, some improvements to dialytic removal have been proposed, each with their own upsides and drawbacks. Longer dialysis sessions and hemodiafiltration, though, have not performed especially well, while larger dialyzers, coupled with a higher dialysate flow, proved to have some efficiency in indoxyl sulfate (IS) clearance, but with reduced impact on patients’ quality of life. More efficient in removing PBUTs was fractionated plasma separation and adsorption, but the risk of occlusive thrombosis was worryingly high. A promising technique for the removal of PBUTs is binding competition, which holds great hopes for future HD. This short review starts by presenting the PBUTs chemistry with emphasis on the chemical interactions with the transport protein, human serum albumin (HSA). Recent membrane-based strategies targeting PBUTs removal are also presented, and their efficiency is discussed.https://www.mdpi.com/2077-0375/12/3/261chronic kidney disease (CKD)protein-bound uremic toxinsOATOCT |
| spellingShingle | Fahimeh Zare Adriana Janeca Seyyed M. Jokar Mónica Faria Maria Clara Gonçalves Interaction of Human Serum Albumin with Uremic Toxins: The Need of New Strategies Aiming at Uremic Toxins Removal Membranes chronic kidney disease (CKD) protein-bound uremic toxins OAT OCT |
| title | Interaction of Human Serum Albumin with Uremic Toxins: The Need of New Strategies Aiming at Uremic Toxins Removal |
| title_full | Interaction of Human Serum Albumin with Uremic Toxins: The Need of New Strategies Aiming at Uremic Toxins Removal |
| title_fullStr | Interaction of Human Serum Albumin with Uremic Toxins: The Need of New Strategies Aiming at Uremic Toxins Removal |
| title_full_unstemmed | Interaction of Human Serum Albumin with Uremic Toxins: The Need of New Strategies Aiming at Uremic Toxins Removal |
| title_short | Interaction of Human Serum Albumin with Uremic Toxins: The Need of New Strategies Aiming at Uremic Toxins Removal |
| title_sort | interaction of human serum albumin with uremic toxins the need of new strategies aiming at uremic toxins removal |
| topic | chronic kidney disease (CKD) protein-bound uremic toxins OAT OCT |
| url | https://www.mdpi.com/2077-0375/12/3/261 |
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