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Abstract: TH-PO0471

Plasma Albumin-Binding Function as an Indicator for Dialyzer Performance for the Removal of Albumin-Bound Toxins

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Koball, Stine, Universitat Rostock, Rostock, MV, Germany
  • Koball, Sebastian, Universitat Rostock, Rostock, MV, Germany
  • Dominik, Adrian, Universitat Rostock, Rostock, MV, Germany
  • Stange, Jan, Universitat Rostock, Rostock, MV, Germany

Group or Team Name

  • Nephrology.
Background

Liver failure is characterized by systemic inflammation and the accumulation of water-soluble and albumin-bound toxins, which contribute to multi-organ dysfunction, including acute kidney injury. Based on the kinetic modeling of serum albumin binding using dansylsarcosine, which selectively targets Sudlow site II - this study introduces a potential diagnostic method for monitoring albumin function and optimizing therapy in patients, complementing traditional performance measures and enhancing individualized treatment precision.

Methods

Binding Function was assessed by dansylsarcosine titration and characterized using a modified Michaelis-Menten model, corrected for intrinsic interference. From this, the two key kinetic parameters—Bmax and Kd—were computated to quantify the functional capacity of albumin.
This method was applied to samples from an in vitro two-compartment model comparing membrane performance of the FX CorDiax 1000 (Fresenius) and Theranova 500 (Baxter) dialyzers within OPAL liver support platform (Albutec GmbH, Germany). Additionaly samples were collected and analyzed for cytokines and albumin-bound toxins via ELISA and photometric assays.

Results

Dansylsarcosine titration revealed no significant differences between the two membrane types. Both dialyzers led to an overall increase in the maximum number of available binding sites and an enhanced affinity for the dansylsarcosine marker, suggesting a partial restoration of binding capacity at the Sudlow II site during albumin dialysis. Aligning with these findings the removal of bilirubin and bile acids is comparable for both filters.

Conclusion

Both membranes increased albumin binding function, potentially enhancing detoxification and reducing renal burden, supporting multi-organ recovery in critically ill patients. However, all presented results are based on in vitro experiments, and clinical studies are needed to validate these findings in vivo. Such studies should also further investigate the role of albumin function in uremic toxin clearance to optimize dialysis strategies for patients with renal insufficiency.

Digital Object Identifier (DOI)