RESUMO
The article is devoted to the theoretical aspects of the development of the effective method for the removal of protein-bound uremic toxins. It is shown that the methods of flow and differential scanning microcalorimetry are sufficient enough for the evaluation of the degree of ligand loading of human serum albumin with protein-bound uremic toxins. The molecules of albumin isolated from blood plasma of the patients being kept on chronic dialysis are demonstrating significant alterations of conformation and complex-forming properties, the correction of which by conventional methods of extracorporeal detoxification (exhaustive dialysis, treatment on synthetic SCN carbons) are practically ineffective. Deliganding of uremic albumin may be successfully performed on conventional carbon haemosorbents upon preliminary separation of blood plasma and its dilution with acetate buffer 1:1 at pH = 5.08. Treatment of the whole blood of patients onto new mass-fractal deliganding carbon, i.e., hemosorbents of HSGD trademark. These HSGD haemosorbents quite effectively could be used for restoration of main parameters of uremic HAS molecules conformation and ligand-binding activity simultaneously with hemodialysis upon the protection by locally performed citrate anticoagulation as an easier and cheaper method for the removal of protein-bound uremic toxins.
Assuntos
Carvão Vegetal/química , Carvão Vegetal/uso terapêutico , Albumina Sérica/efeitos dos fármacos , Toxinas Biológicas/sangue , Toxinas Biológicas/química , Uremia/sangue , Uremia/tratamento farmacológico , Adsorção , Sítios de Ligação , Varredura Diferencial de Calorimetria/métodos , Carvão Vegetal/metabolismo , Furanos/sangue , Hemoperfusão , Hipuratos/sangue , Humanos , Concentração de Íons de Hidrogênio , Indicã/sangue , Membranas Artificiais , Plasma/metabolismo , Propionatos/sangue , Ligação Proteica , Valores de Referência , Diálise Renal/métodos , Albumina Sérica/metabolismo , Resultado do TratamentoRESUMO
In 14 children with purulent septic diseases, the method of biohemosorption with the use of a porcine spleen was used. In 13 children, the treatment was effective. One child with bilateral uretherohydronephrosis, pyonephrosis, urosepsis, signs of aggravating polyorganic failure died. The data obtained are indicative of the expediency to use biohemosorption for treatment of children with purulent septic diseases.
