Antibody response to Engerix-B and Recombivax-HB hepatitis B vaccination in end-stage renal disease

Recombivax-HB (REC) and Engerix-B (ENG) are FDA-approved vaccines for hepatitis B virus (HBV) in end-stage renal disease (ESRD). This study compares antibody response rates between them in routine clinical practice. Patients completing the recommended 40 mug dose of REC (3 doses) or ENG (4 doses) between January 1, 2000 to April 30, 2003 were eligible. Patients with prior positive HBV surface antigen (HBsAg) or antibody (HBsAb) test results were excluded. The conversion rate and persistence of protective titer (HBsAb titer>or=10 IU/mL) were tracked for 1 year. A supplemental analysis of a one-to-one matched patient sample was also performed. REC patients (N=885) were older, had longer dialysis vintage, and had a larger proportion of whites than ENG patients (N=13,661). Cumulative conversion response was greater in ENG (58%) than REC (40%) at 1 year (p<0.0001). The odds ratio for response to ENG compared with REC was 1.96 (95% limits: 1.56, 2.45; p<0.0001) adjusted for age, gender, race, diabetes, vintage, BSA, hemoglobin, and eKt/V. Persistent protective HBsAb after 1 year was 77% (ENG) vs. 53% (REC). HBsAg was positive in 208 ENG patients (1.5%) with all but 1 because of transient, vaccine-related antigenemia. The difference in conversion response favoring ENG persisted in a one-to-one sample matched for age, gender, race, modality, and dialysis vintage. The study found higher seroconversion response to ENG compared with REC at several time points up to 1 year. Protective HBsAb disappeared in 23-47% of patients 1 year later, validating CDC recommendations to re-test HBsAb yearly. The observed difference in response rates may be related to the extra ENG dose given at the second month (0, 1, 2, 6 regimen). The study raises a hypothesis that requires confirmation in a prospective clinical trial.     

Comparison of different separative techniques in the quantitative determination of active compound enclosed in liposomal systems

The suitability of three different separative techniques, dialysis, gel filtration and centrifugation, for determining the percentage of active compound included (PAI) in liposomal systems was assessed. Two model compounds, glucose and vitamin E acetate were encapsulated in dipalmitoylphosphatidylcholine (DPPC), soybean lecithin (SL) and hydrogenated soybean lecithin (HSL) multilamellar vesicles (MLV). Vitamin E acetate PAI values from DPPC MLV liposomes obtained by dialysis, gel filtration and centrifugation, were compared with those determined by differential scanning calorimetry. Glucose PAI values from DPPC MLV liposomes, obtained using the same separative techniques, were compared with that calculated by taking into account the glucose content of the liposome internal aqueous phase on the basis of liposome mean size determined by light scattering.
Vitamin E acetate and glucose PAI values from SL and HSL liposomes were compared with those obtained for DPPC liposomes. Dialysis proved suitable for PAI determination for both lipophilic and hydrophilic compounds, centrifugation was found to be suitable only for the determination of lipophilic compound PAI values while gel filtration using Sephadex G-25M proved inadequate for the determination of PAI values for both lipophilic and hydrophilic compounds in the experimental conditions used in this study.     

Inorganic ligand-modified, colloid-enhanced ultrafiltration: A novel method for removing uranium from aqueous solution

Inorganic ligand-modified, colloid-enhanced ultrafiltration (ILM-CEUF) is as a novel membrane-based separation method for selectively removing target ions from aqueous solution. Traditional colloid-enhanced ultrafiltration (CEUF) is a well-established membrane-based separation technique that can be used to separate metal ions from other aqueous solution components. Ligand-modified, colloid-enhanced ultrafiltration (LM-CEUF) uses organic ligands that selectively complex target ions and also associate with a water-soluble colloid, such as a surfactant micelle or polyelectrolyte. The colloid, associated -ligand, and target ion are then concentrated using an ultrafilter, producing a filtrate with a low concentration of the target ion. While traditional LM-CEUF techniques are able to provide quantitative separations of a variety of ionic pollutants, the high costs of the chelating agents make such techniques nonviable in most remediation schemes. This study investigated the replacement of organic ligands with carbonate for the selective removal of U(VI) from aqueous solution.In slightly to moderately basic solutions containing carbonate, UO₂(CO₃)₃⁴⁻ can be made to dominate the U(VI) speciation. Using poly(diallyldimethylammonium) chloride, the effectiveness and efficiency of ILM-CEUF for removing U(VI) from other aqueous solution components was investigated as a function of carbonate concentration, pH, and ionic strength. Uranium separations of greater than 99.6% were achieved; even in the presence of large excesses of competing ions. The specific separation of U(VI) from Sr²⁺ was also examined.     

Interaction between anionic dyes and cationic flocculant P(AM-DMC) in synthetic solutions

Copolymer of acrylamide and 2-[(methacryloyloxy)ethyl]trimethylammonium chloride [P(AM-DMC)] is found to be effective to combine anionic dyes with strong aqueous solubility. This work aims mainly at revealing the interaction between anionic dyes and [P(AM-DMC)] by running jar test, spectra analysis and equilibrium dialysis experiments. The results show that P(AM-DMC) effectively decolorizes the tested strong water soluble anionic dyes, such as acidic, reactive and direct dyes, from their aqueous solutions under mild acidic and neutral conditions. Higher cationicity and optimal dose of flocculant P(AM-DMC) have to be used to achieve satisfactory and effective decolorization. Comparison of IR spectra of dye, flocculant P(AM-DMC) and the floc formed indicates chemical interaction occurred between sulfonic groups of dye and quaternary ammonium of flocculant. Plots of r-logC suggest cooperative interaction exists evidently for some dyes tested. Addition of KCl or urea reduces binding extent evidently, which shows the importance of electrostatic and hydrophobic interaction. Therefore the interaction between dyes tested and P(AM-DMC) might be controlled by hydrophobic, cooperative interaction and energetic interaction which includes chemical and electrostatic interactions.     

模制瓶及盐水透析对人血白蛋白制品中铝离子残留量的影响

目的 探讨模制瓶及盐水透析对人血白蛋白制品中铝离子残留量的影响.方法 采用原子吸收法检测5％、10％、20％和25％4种规格人血白蛋白空白制剂(不含人血白蛋白,仅含辛酸钠和氯化钠等辅料配方制剂,不同规格空白制剂的辅料配方相同,仅浓度不同)的铝离子含量,随后分别灌装至不同厂家的模制瓶中,于57℃存放0、2、4、6和8周,...     

Acute Kidney Injury in COVID-19

COVID-19 is mainly considered a respiratory illness, but since SARS-CoV-2 uses the angiotensin converting enzyme 2 receptor (ACE2) to enter human cells, the kidney is also a target of the viral infection. Acute kidney injury (AKI) is the most alarming condition in COVID-19 patients. Recent studies have confirmed the direct entry of SARS-CoV-2 into the renal cells, namely podocytes and proximal tubular cells, but this is not the only pathomechanism of kidney damage. Hypovolemia, cytokine storm and collapsing glomerulopathy also play an important role. An increasing number of papers suggest a strong association between AKI development and higher mortality in COVID-19 patients, hence our interest in the matter. Although knowledge about the role of kidneys in SARS-CoV-2 infection is changing dynamically and is yet to be fully investigated, we present an insight into the possible pathomechanisms of AKI in COVID-19, its clinical features, risk factors, impact on hospitalization and possible ways for its management via renal replacement therapy.     

A Novel Formulation of Glucose-Sparing Peritoneal Dialysis Solutions with l-Carnitine Improves Biocompatibility on Human Mesothelial Cells

The main reason why peritoneal dialysis (PD) still has limited use in the management of patients with end-stage renal disease (ESRD) lies in the fact that the currently used glucose-based PD solutions are not completely biocompatible and determine, over time, the degeneration of the peritoneal membrane (PM) and consequent loss of ultrafiltration (UF). Here we evaluated the biocompatibility of a novel formulation of dialytic solutions, in which a substantial amount of glucose is replaced by two osmometabolic agents, xylitol and l-carnitine. The effect of this novel formulation on cell viability, the integrity of the mesothelial barrier and secretion of pro-inflammatory cytokines was evaluated on human mesothelial cells grown on cell culture inserts and exposed to the PD solution only at the apical side, mimicking the condition of a PD dwell. The results were compared to those obtained after exposure to a panel of dialytic solutions commonly used in clinical practice. We report here compelling evidence that this novel formulation shows better performance in terms of higher cell viability, better preservation of the integrity of the mesothelial layer and reduced release of pro-inflammatory cytokines. This new formulation could represent a step forward towards obtaining PD solutions with high biocompatibility.     

Association between patient psychosocial characteristics and receipt of in‐center nocturnal hemodialysis among prevalent dialysis patients

Introduction: Compared to traditional in‐center hemodialysis (HD), in‐center nocturnal dialysis (INHD) is characterized by longer sessions and nighttime administration, which may lead to better outcomes for some patients. Given the importance of patient choice in the decision to initiate INHD, we explored associations between patients’ psychosocial characteristics and their receipt of INHD. Methods: Among hemodialysis patients at a medium‐sized dialysis organization, we identified INHD patients as those for whom ≥80% of dialysis sessions were INHD sessions—starting at 6:30 pm or later and lasting ≥5 hours—over the 3 months (≥20 sessions total) after their first INHD session. We extracted dialysis session data from electronic medical records and psychosocial data from social worker assessments. We tested associations of patients’ psychosocial characteristics—as well as demographic and clinical characteristics—with INHD receipt among all hemodialysis patients (INHD and HD) in bivariate analyses and multivariable logistic regression models. Findings: Among 759 patients with complete data, we identified 47 (6.2%) as INHD patients. On average, these patients were more likely than HD patients to be employed (full‐time 10.6% vs. 5.2%; part‐time 17.0% vs. 4.2%; P < 0.001), and they were significantly less likely to require ambulatory assistance (14.9% vs. 39.6%, P < 0.001). In multivariable regressions, we found that part‐time employment (versus being unemployed) was associated with a 7.1 percentage‐point higher likelihood of being an INHD patient (P = 0.01), and the negative association with ambulatory assistance needs approached statistical significance (P = 0.056). No other psychosocial factors included in this main regression analysis were statistically significantly associated with INHD patient status. Discussion: Researchers comparing the outcomes of patients undergoing INHD versus other treatment modalities will need to account for differences in employment status—and other factors like requiring ambulatory assistance and age which may predict the ability to work—between INHD users and comparison patients to avoid bias in estimates.     

Branched Polyvinyl Alcohol Hybrid Membrane for Acid Recovery via Diffusion Dialysis

A branched polymer was prepared by grafting allyltrimethylammonium chloride onto polyvinyl alcohol (PVA) via free‐radical polymerization. Afterwards, a series of hybrid membranes were prepared by sol‐gel cross‐linking between quaternary ammonium‐PVA and tetraethoxysilane. The obtained membranes were characterized in terms of infrared spectroscopy, ion exchange capacity, water uptake, linear expansion ratio, and acid resistance. The thermal properties of the membranes were investigated as well. The diffusion dialysis performances of the membranes were tested by using a simulated feed solution containing HCl and FeCl₂. The diffusion dialysis coefficients and the separation factors were much better than those of the commercial DF‐120 membrane.