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Safety of electrooxidation for urea removal in a wearable artificial kidney is compromised by formation of glucose degradation products
Author(s) -
Gelder Maaike K.,
Vollenbroek Jeroen C.,
Lentferink Babette H.,
Hazenbrink Diënty H. M.,
Besseling Paul J.,
Simonis Frank,
Giovanella Silvia,
Ligabue Giulia,
Bajo Rubio Maria A.,
Cappelli Gianni,
Joles Jaap A.,
Verhaar Marianne C.,
Gerritsen Karin G. F.
Publication year - 2021
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/aor.14040
Subject(s) - methylglyoxal , chemistry , urea , glyoxal , degradation (telecommunications) , carbon dioxide , chromatography , biochemistry , organic chemistry , enzyme , computer science , telecommunications
A major challenge for the development of a wearable artificial kidney (WAK) is the removal of urea from the spent dialysate, as urea is the waste solute with the highest daily molar production and is difficult to adsorb. Here we present results on glucose degradation products (GDPs) formed during electrooxidation (EO), a technique that applies a current to the dialysate to convert urea into nitrogen, carbon dioxide, and hydrogen gas. Uremic plasma and peritoneal effluent were dialyzed for 8 hours with a WAK with and without EO‐based dialysate regeneration. Samples were taken regularly during treatment. GDPs (glyoxal, methylglyoxal, and 3‐deoxyglucosone) were measured in EO‐ and non‐EO‐treated fluids. Glyoxal and methylglyoxal concentrations increased 26‐ and 11‐fold, respectively, in uremic plasma (at [glucose] 7 mmol/L) and 209‐ and 353‐fold, respectively, in peritoneal effluent (at [glucose] 100 mmol/L) during treatment with EO, whereas no change was observed in GDP concentrations during dialysate regeneration without EO. EO for dialysate regeneration in a WAK is currently not safe due to the generation of GDPs which are not biocompatible.