Using Counter Equilibrium Dialysis (CED) to Increase Confidence in the Measurement of Free Fraction for Challenging Compounds

The confidence in fraction unbound (ƒu) using equilibrium dialysis (ED) is often questioned (e.g., highly bound, labile compounds) due to uncertainty in whether true equilibrium is achieved. Different methods have been developed to increase confidence in ƒu measurements, such as the presaturation, dilution, and bi-directional ED methods. However, confidence in ƒu measurement can still suffer due to non-specific binding and inter-run variations introduced during equilibrium and analysis. To address this concern, we introduce an orthogonal approach called counter equilibrium dialysis (CED) in which non-labeled and isotope-labeled compounds are dosed counter-directionally in rapid equilibrium dialysis (RED). ƒu values of both non-labeled and labeled compounds are measured simultaneously in the same run. These tactics not only minimize non-specific binding and inter-run variability but also enable the confirmation of true equilibrium. If equilibrium is reached in both dialysis directions, the ƒu for the non-labeled compound and the labeled compound will converge. The refined methodology was extensively tested with various compounds of diverse physicochemical properties and plasma binding characteristics. Our results demonstrated that, by using the CED method, ƒu values for a wide range of compounds could be accurately determined with significantly improved confidence, including the challenging highly bound and labile compounds.

Electrodialysis desalination: The impact of solution flowrate (or Reynolds number) on fluid dynamics throughout membrane spacers

The incorporation of a spacer among membranes has a major influence on fluid dynamics and performance metrics. Spacers create feed channels and operate as turbulence promoters to increase mixing and reduce concentration/temperature polarization effects. However, spacer geometry remains unoptimized, and studies continue to investigate a wide range of commercial and custom-made spacer designs. The in-depth discussion of the present systematic review seeks to discover the influence of Reynolds number or solution flowrate on flow hydrodynamics throughout a spacer-filled channel. A fast-flowing solution sweeping one membrane's surface first, then the neighboring membrane's surface produces good mixing action, which does not happen commonly at laminar solution flowrates. A sufficient flowrate can suppress the polarization layer, which may normally require the utilization of a simple feed channel rather than complex spacer configurations. When a recirculation eddy occurs, it disrupts the continuous flow and effectively curves the linear fluid courses. The higher the flowrate, the better the membrane performance, the higher the critical flux (or recovery rate), and the lower the inherent limitations of spacer design, spacer shadow effect, poor channel hydrodynamics, and high concentration polarization. In fact, critical flow achieves an acceptable balance between improving flow dynamics and reducing the related trade-offs, such as pressure losses and the occurrence of concentration polarization throughout the cell. If the necessary technical flowrate is not used, the real concentration potential for transport is relatively limited at low velocities than would be predicted based on bulk concentrations. Electrodialysis stack therefore may suffer from the dissociation of water molecules. Next studies should consider that applying a higher flowrate results in greater process efficiency, increased mass transfer potential at the membrane interface, and reduced stack thermal and electrical resistance, where pressure drop should always be indicated as a consequence of the spacer and circumstances used, rather than a problem.

Association of Urinary Potassium Excretion with Blood Pressure Variability and Cardiovascular Outcomes in Patients with Pre-Dialysis Chronic Kidney Disease

Dietary potassium intake is a dilemma in patients with chronic kidney disease (CKD). We investigated the association of urine potassium excretion, a surrogate for dietary potassium intake, with blood pressure variability (BPV) and cardiovascular (CV) outcomes in patients with pre-dialysis CKD. A total of 1860 participants from a cohort of pre-dialysis CKD (KNOW-CKD) patients were divided into the quartiles by spot urine potassium-to-creatinine ratio. The first quartile (26.423 ± 5.731 mmol/gCr) was defined as low urine potassium excretion. Multivariate linear regression analyses revealed an independent association of low urine potassium excretion with high BPV (adjusted β coefficient 1.163, 95% confidence interval 0.424 to 1.901). Cox regression analyses demonstrated that, compared to high urine potassium excretion, low urine potassium excretion is associated with increased risk of CV events (adjusted hazard ratio 2.502, 95% confidence interval 1.162 to 5.387) but not with all-cause mortality. In conclusion, low urine potassium excretion is associated with high BPV and increased risk of CV events in patients with pre-dialysis CKD. The restriction of dietary potassium intake should be individualized in patients with pre-dialysis CKD.

Study on the Effectiveness of Simultaneous Recovery and Concentration of 1-Ethyl-3-methylimidazolium Chloride Ionic Liquid by Electrodialysis with Heterogeneous Ion-Exchange Membranes

Due to the extensive range of ionic liquids (ILs) used in industry, an efficient recovery method is needed. In this study, the effectiveness of a simultaneous concentration and recovery method was investigated for 1-ethyl-3-methylimidazolium chloride ([Emim]Cl), an IL that was recovered using electrodialysis (ED). The optimal operational parameters for electrodialytic recovery were determined empirically. The variables that were investigated included the concentration of IL, applied voltage, linear flow velocity and the diluate-to-concentrate volume ratio. The recovery of [Emim]Cl, the concentration degree, the [Emim]Cl flux across membranes, the current efficiency, as well as the energy consumption were determined. The results of the experiments confirmed that [Emim]Cl concentration and recovery can be achieved using ED. The highest ED efficiency was obtained when a 2 V electric potential per one membrane pair was applied, using a 2 cm/s linear flow velocity, and by adjusting to 0.2 M IL in the feed solution. By using ED, a 2.35-fold concentration of [Emim]Cl with a recovery of 90.4% could be achieved when the diluate-to-concentrate volume ratio was 2. On the other hand, a 3.35-fold concentration of [Emim]Cl with a recovery of 81.7% could be obtained when the diluate-to-concentrate volume ratio was increased to 5.

Roxadustat for dialysis patients with erythropoietin hypo-responsiveness: a single-center, prospective investigation

Dialysis patients with erythropoietin hypo-responsiveness suffered from refractory anemia. Roxadustat reversibly binds and inhibits hypoxia-inducible factor-prolyl hydroxylase (HIF-PHD), resulting in increased endogenous EPO which stimulates erythropoiesis, theoretically has an advantage over exogenous EPO in anti-anemia therapy. From September 2019 to October 2020, 32 dialysis patients with hypo-responsiveness to erythropoietin were evaluated. During the 24-week follow-up period, all patients were taken off erythropoietin and switched to roxadustat. Dosage adjustments were administrated according to the fluctuation of hemoglobin level during the treatment. Parameters about anemia, iron metabolism and biochemical indexes were collected, and adverse events were recorded. A total of 31 patients completed the clinical observation, with varying degrees of malnutrition-inflammation. Post treatment, the levels of transferrin and total iron-binding capacity were increased, while that of transferrin saturation and cholesterol decreased. 15 cases (accounting for 48.39%, designated as fulfilled group) met the target level of hemoglobin, while 16 cases (51.61%, non-fulfilled group) did not. The baseline conditions of the above two groups were compared. The levels of hypersensitive C-reactive protein, interleukin-6 and serum ferritin in the non-fulfilled group were higher than those in the fulfilled group, and the levels of residual renal function, serum albumin, iron, transferrin and total iron-binding capacity were lower than those in the fulfilled group. Linear regression analysis showed that increase of HsCRP had a negative effect on the improvement of Hb. One case of adverse reaction grade 3 and four cases of grade 2 occurred throughout the study, yet all were relieved after therapy. Significant anti-anemia effects could be achieved in most patients with erythropoietin hypo-responsiveness after treatment with roxadustat, accompanied by relatively mild and rare adverse reactions. The malnutrition-inflammation states of patients may interfere with the anti-anemia effect of roxadustat, and iron utilization is more important than iron storage in anemia improvement.

The Concentration of Organic Acids in Cranberry Juice Modulates the Gut Microbiota in Mice

A daily consumption of cranberry juice (CJ) is linked to many beneficial health effects due to its richness in polyphenols but could also awake some intestinal discomforts due to its organic acid content and possibly lead to intestinal inflammation. Additionally, the impact of such a juice on the gut microbiota is still unknown. Thus, this study aimed to determine the impacts of a daily consumption of CJ and its successive deacidification on the intestinal inflammation and on the gut microbiota in mice. Four deacidified CJs (DCJs) (deacidification rates of 0, 40, 60, and 80%) were produced by electrodialysis with bipolar membrane (EDBM) and administered to C57BL/6J mice for four weeks, while the diet (CHOW) and the water were ad libitum. Different parameters were measured to determine intestinal inflammation when the gut microbiota was profiled. Treatment with a 0% DCJ did not induce intestinal inflammation but increased the gut microbiota diversity and induced a modulation of its functions in comparison with control (water). The effect of the removal of the organic acid content of CJ on the decrease of intestinal inflammation could not be observed. However, deacidification by EDBM of CJ induced an additional increase, in comparison with a 0% DCJ, in the Lachnospiraceae family which have beneficial effects and functions associated with protection of the intestine: the lower the organic acid content, the more bacteria of the Lachnospiraceae family and functions having a positive impact on the gut microbiota.

Estimated SARS-CoV-2 Seroprevalence in US Patients Receiving Dialysis 1 Year After the Beginning of the COVID-19 Pandemic

IMPORTANCE

Seroprevalence studies complement data on detected cases and attributed deaths in assessing the cumulative spread of the SARS-CoV-2 virus.

OBJECTIVE

To estimate seroprevalence of SARS-CoV-2 antibodies in patients receiving dialysis and adults in the US in January 2021 before the widespread introduction of COVID-19 vaccines.

DESIGN, SETTING, AND PARTICIPANTS

This cross-sectional study used data from the third largest US dialysis organization (US Renal Care), which has facilities located nationwide, to estimate SARS-CoV-2 seroprevalence among US patients receiving dialysis. Remainder plasma (ie, plasma that would have otherwise been discarded) of all patients receiving dialysis at US Renal Care facilities from January 1 to 31, 2021, was tested for SARS-CoV-2 antibodies. Patients were excluded if they had a documented dose of SARS-CoV-2 vaccination or if a residence zip code was missing from electronic medical records. Crude seroprevalence estimates from this sample (January 2021) were standardized to the US adult population using the 2018 American Community Survey 1-year estimates and stratified by age group, sex, self-reported race/ethnicity, neighborhood race/ethnicity composition, neighborhood income level, and urban or rural status. These data and case detection rates were then compared with data from a July 2020 subsample of patients who received dialysis at the same facilities.

EXPOSURES

Age, sex, race/ethnicity, and region of residence as well as neighborhood race/ethnicity composition, poverty, population density, and urban or rural status.

MAIN OUTCOMES AND MEASURES

The spike protein receptor-binding domain total antibody assay (Siemens Healthineers; manufacturer-reported sensitivity of 100% and specificity of 99.8%) was used to estimate crude SARS-CoV-2 seroprevalence in the unweighted sample, and then the estimated seroprevalence rates for the US dialysis and adult populations were calculated, adjusting for age, sex, and region.

RESULTS

A total of 21 464 patients (mean [SD] age, 63.1 [14.2] years; 12 265 men [57%]) were included in the unweighted sample from January 2021. The patients were disproportionately older (aged 65-79 years, 7847 [37%]; aged ≥80 years, 2668 [12%]) and members of racial/ethnic minority groups (Hispanic patients, 2945 [18%]; non-Hispanic Black patients, 4875 [29%]). Seroprevalence of SARS-CoV-2 antibodies was 18.9% (95% CI, 18.3%-19.5%) in the sample, with a seroprevalence of 18.7% (95% CI, 18.1%-19.2%) standardized to the US dialysis population, and 21.3% (95% CI, 20.3%-22.3%) standardized to the US adult population. In the unweighted sample, younger persons (aged 18-44 years, 25.9%; 95% CI, 24.1%-27.8%), those who self-identified as Hispanic or living in Hispanic neighborhoods (25.1%; 95% CI, 23.6%-26.4%), and those living in the lowest-income neighborhoods (24.8%; 95% CI, 23.2%-26.5%) were among the subgroups with the highest seroprevalence. Little variability was observed in seroprevalence by geographic region, population density, and urban or rural status in the January 2021 sample (largest regional difference, 1.2 [95% CI, 1.1-1.3] higher odds of seroprevalence in residents of the Northeast vs West).

CONCLUSIONS AND RELEVANCE

In this cross-sectional study of patients receiving dialysis in the US, fewer than 1 in 4 patients had evidence of SARS-CoV-2 antibodies 1 year after the first case of SARS-CoV-2 infection was detected in the US. Results standardized to the US population indicate similar prevalence of antibodies among US adults. Vaccine introduction to younger individuals, those living in neighborhoods with a large population of racial/ethnic minority residents, and those living in low-income neighborhoods may be critical to disrupting the spread of infection.

Effect of Renamezin upon attenuation of renal function decline in pre-dialysis chronic kidney disease patients: 24-week prospective observational cohort study

Renamezin^® is a modified capsule-type oral spherical adsorptive carbon which lowers indoxyl sulfate levels in patients with advanced chronic kidney disease (CKD). This 24-week prospective observational cohort study was performed to evaluate the effect of Renamezin^® upon attenuation of renal function decline. A total of 1,149 adult patients with baseline serum creatinine 2.0–5.0 mg/dL were enrolled from 22 tertiary hospital in Korea from April 2016 to September 2018. Among them, a total of 686 patients completed the study and were included in the intention-to-treat analysis. A total of 1,061 patients were included in the safety analysis. The mean age was 63.5 years and male patients were predominant (63.6%). Most of the patients (76.8%) demonstrated high compliance with study drug (6g per day). After 24 week of treatment, serum creatinine was increased from 2.86±0.72 mg/dL to 3.06±1.15 mg/dL (p<0.001), but estimated glomerular filtration rate was not changed significantly during observation period (22.3±6.8 mL/min/1.73m² to 22.1±9.1 mL/min/1.73m², p = 0.243). Patients with age over 65 years old and those under good systolic blood pressure control <130 mmHg were most likely to get benefit from Renamezin^® treatment to preserve renal function. A total of 98 (9.2%) patients out of 1,061 safety population experienced 134 adverse events, of which gastrointestinal disorders were the most common. There were no serious treatment-related adverse events. Renamezin^® can be used safely to attenuate renal function decline in moderately advanced CKD patients.

Clinical efficacy of biomarkers for evaluation of volume status in dialysis patients

Volume status is a key parameter for cardiovascular-related mortality in dialysis patients. Although N-terminal pro-B-type natriuretic peptide (NT-proBNP), myeloperoxidase, copeptin, and pro-adrenomedullin have been reported as volume markers, the relationship between body fluid status and volume markers in dialysis patients is uncertain. Therefore, we investigated the utility of volume status biomarkers based on body composition monitor (BCM) analyses.We enrolled pre-dialysis, hemodialysis (HD), and peritoneal dialysis (PD) patients and age- and gender-matched healthy Korean individuals (N = 80). BCM and transthoracic echocardiography were performed and NT-proBNP, myeloperoxidase, copeptin, and pro-adrenomedullin concentrations were measured. Relative hydration status (ΔHS, %) was defined in terms of the hydration status-to-extracellular water ratio with a cutoff of 15%, and hyperhydrated status was defined as ΔHS > 15%.Although there were no significant differences in total body water, extracellular water, or intracellular water among groups, mean amount of volume overload and hyperhydrated status were significantly higher in HD and PD patients compared with control and pre-dialysis patients. Mean amount of volume overload and hyperhydrated status were also significantly associated with higher NT-proBNP and pro-adrenomedullin levels in HD and PD patients, although not with myeloperoxidase or copeptin levels. Furthermore, they were significantly associated with cardiac markers (left ventricular mass index, ejection fraction, and left atrial diameter) in HD and PD patients compared with those in the control and pre-dialysis groups.On the basis of increased plasma NT-proBNP and pro-adrenomedullin concentrations, we might be able to make predictions regarding the volume overload status of dialysis patients, and thereby reduce cardiovascular-related mortality through appropriate early volume control.

Influence of acid/base activation treatment in the performance of recycled electromembrane for fresh water production by electrodialysis

In this study, an activation treatment for recycled anion exchange membranes is proposed. Following the circular economy approach, these membranes were prepared by using end-of-life reverse osmosis membranes as mechanical support. The end-of-life membrane was previously used and discarded by desalination plants after overcoming its lifespan. The activation treatment was based on the subsequent immersion of the membranes in diluted acid and alkali solutions. This treatment promoted the complete dissociation of the functional groups in the membrane, making them more reactive to the counter ions. The effects of acid and alkali concentrations and exposition times on the electrochemical properties were studied and the best combination was selected. In such a way, a decrease of 37% in membrane electrical resistance was achieved. The performance of activated and non-activated membranes in brackish water desalination by electrodialysis was compared. The results showed that the proposed activation treatment increased the flux of fresh water more than four-fold (from 1.2 to 4.9 L h^-1·m^-2), with a considerable reduction of energy consumption (from 5.2 to 3.0 kWh·m^-3) and a great improvement in current efficiency (from 38% to 71%). In conclusion, this work shows a simple and low cost methodology for the improvement of the electrochemical properties of recycled electromembranes and thus, their performance in electrodialysis.

Predicting Contrast-Induced Renal Complications

Chronic kidney disease is a major risk factor for developing coronary artery disease, serving as an independent risk factor while overlapping with other risk factors. Percutaneous coronary intervention is a cornerstone of therapy for coronary artery disease and requires contrast media, which can contribute to renal injury. Identifying patients at risk for contrast-induced nephropathy is critical for preventing renal injury, which is associated with short- and long-term mortality. Determination of the potential risk for contrast-induced nephropathy and a new need for dialysis using validated risk prediction tools is a method of identifying patients at high risk for this complication.

How Electrical Heterogeneity Parameters of Ion-Exchange Membrane Surface Affect the Mass Transfer and Water Splitting Rate in Electrodialysis

Electrodialysis (ED) has been demonstrated as an effective membrane method for desalination, concentration, and separation. Electroconvection (EC) is a phenomenon which can essentially increase the mass transfer rate and reduce the undesirable water splitting effect. Efforts by a number of researchers are ongoing to create conditions for developing EC, in particular, through the formation of electrical heterogeneity on the membrane surface. We attempt, for the first time, to optimize the parameters of surface electrical heterogeneity for ion-exchange membranes used in a laboratory ED cell. Thirteen different patterns on the surface of two Neosepta anion-exchange membranes, AMX and AMX-Sb, were tested. Low-conductive fluoropolymer spots were formed on the membrane surface using the electrospinning technique. Spots in the form of squares, rectangles, and circles with different sizes and distances between them were applied. We found that the spots' shape did not have a visible effect. The best effect, i.e., the maximum mass transfer rate and the minimum water splitting rate, was found when the spots' size was close to that of the diffusion layer thickness, δ (about 250 μm in the experimental conditions), and the distance between the spots was slightly larger than δ, such that the fraction of the screened surface was about 20%.

Evaluation of the feasibility of short-term electrodialysis for separating naturally occurring fluoride from instant brick tea infusion

BACKGROUND

Removing excessive naturally occurring fluoride from tea and/or infusions is difficult because the process has low efficiency and causes secondary pollution. In this study, a novel electrodialysis (ED) technology was developed. We examined the effect of crucial parameters (electrolyte concentration, operation voltage, ED duration and initial concentration of the tea infusion) on defluoridation performance using a highly efficient ion-exchange membrane with five-compartment cells.

RESULTS

The most effective ED system results were obtained at an electrolyte concentration of 10 g kg^-1 and operating voltage of 20 V. Moreover, the fluoride removal capacity (10.70-66.93%) was highly dependent on the ED duration (1-15 min) and initial concentration of the tea infusion (0.5-10 g kg^-1 ). The longer the ED duration and the lower the initial concentration, the higher was the defluoridation performance. During ED, limited loss of the main inclusions (total polyphenols, catechins, caffeine and selected ions) was observed. Furthermore, the D201 anion resin-filled ED stack (0.5-5 g) and improvement of concentrate compartment electrolyte (≥5 times the dilute compartment electrolyte) in the ED system enhanced the defluoridation rate significantly.

CONCLUSION

ED is a potentially effective method that can be used for defluoridation in the deep processing of tea products. © 2019 Society of Chemical Industry.

Isolating Urinary Extracellular Vesicles as Biomarkers for Diabetic Disease

Extracellular vesicles are lipid bilayer enclosed structures secreted by all cell types. Their cargo includes proteins, lipids, RNAs, and DNA, which reflect the physiological state of their cells of origin. Recently, urinary extracellular vesicles have emerged as a valuable source of biomarkers for kidney and systemic disease.Unfortunately, all existing methods for extracellular vesicle isolation from urine are time consuming and/or expensive. Thus, they are not adaptable to large-scale studies and unsuitable for clinical use without special equipment in the laboratory. Recently, our group has devised a set of new, quick, simple, and inexpensive techniques, based on hydrostatic filtration dialysis (HFD) of urine extremely suitable for diagnostic purposes. This novel approach represents a great potential for new diagnostics and understanding disease biology in general and brings the biomarker detection to the scope of all laboratories.

Predicting drug release kinetics from nanocarriers inside dialysis bags

Dialysis methods are frequently used to determine the in vitro drug release kinetics of nanoparticle drug delivery systems. However, the need for the released drug to diffuse through the dialysis membrane delays its appearance in the sampling compartment. Thus, the apparent drug release data outside the dialysis bag typically does not match the desired release kinetics inside the bag adjacent to the nanocarriers. To address this issue, here we describe a simple approach to determine the actual drug release kinetics from nano drug carriers inside the dialysis bag from the experimental data measured from the sampling compartment. First, a calibration experiment is carried out to determine the diffusion barrier properties of the dialysis membranes. The apparent drug release profile of the nanocarrier is then determined using the dialysis method, and a mathematical model is applied to determine the actual drug release kinetics from the experimental data. The model was tested on DOXIL® (doxorubicin liposomes), and an excellent agreement was found between the predicted and measured drug concentration inside the dialysis membranes. By taking the barrier effects of dialysis membranes into consideration, our model independent of drug carrier not only enables the proper interpretation of the data from dialysis studies but also helps to evaluate the dialysis methodology applied to in vitro drug release assays.

Association between intravenous contrast media exposure and non-recovery from dialysis-requiring septic acute kidney injury: a nationwide observational study

PURPOSE

This study aimed to examine the association between the use of intravenous contrast and non-recovery from dialysis-requiring acute kidney injury (AKI-D) and in-hospital mortality among patients with sepsis.

METHODS

This was a retrospective observational study using the Japanese Diagnosis Procedure Combination inpatient database between January 2011 and December 2016. We identified patients with septic AKI who began continuous renal replacement therapy (RRT) within 2-days of admission and underwent computed tomography. We compared patients with AKI-D with and without the use of intravenous contrast for computed tomography and performed propensity score matching to adjust for confounders for the association between exposure to intravenous contrast and outcomes, including a composite outcome of in-hospital mortality and RRT dependence at discharge and RRT duration.

RESULTS

From 3782 and 6619 patients with septic AKI-D with and without intravenous contrast exposure, respectively, 3485 propensity score-matched pairs were generated. No significant differences were found in the outcomes between the propensity score-matched groups: a composite outcome of in-hospital mortality and RRT dependence, 49.6% vs. 50.2% (odds ratio (OR) 0.98; 95% CI (confidence interval) 0.88, 1.07); in-hospital mortality, 45.3% vs. 46.1% (OR 0.97; 95% CI 0.87, 1.06); RRT dependence, 4.4% vs 4.1% (OR 1.08; 95% CI 0.85, 1.31); and median (interquartile range) of RRT duration, 4 [2-11] days vs. 4 [2-11] days (P = 0.58).

CONCLUSIONS

This large observational study did not support an association between intravenous contrast media and adverse in-hospital outcomes in patients with septic AKI-D. Further studies are warranted to assess the generalizability.

Partial Fluxes of Phosphoric Acid Anions through Anion-Exchange Membranes in the Course of NaH2PO4 Solution Electrodialysis

Electrodialysis (ED) with ion-exchange membranes is a promising method for the extraction of phosphates from municipal and other wastewater in order to obtain cheap mineral fertilizers. Phosphorus is transported through an anion-exchange membrane (AEM) by anions of phosphoric acid. However, which phosphoric acid anions carry the phosphorus in the membrane and the boundary solution, that is, the mechanism of phosphorus transport, is not yet clear. Some authors report an unexpectedly low current efficiency of this process and high energy consumption. In this paper, we report the partial currents of H2PO4-, HPO42-, and PO43- through Neosepta AMX and Fujifilm AEM Type X membranes, as well as the partial currents of H2PO4- and H+ ions through a depleted diffusion layer of a 0.02 M NaH2PO4 feed solution measured as functions of the applied potential difference across the membrane under study. It was shown that the fraction of the current transported by anions through AEMs depend on the total current density/potential difference. This was due to the fact that the pH of the internal solution in the membrane increases with the growing current due to the increasing concentration polarization (a lower electrolyte concentration at the membrane surface leads to higher pH shift in the membrane). The HPO42- ions contributed to the charge transfer even when a low current passed through the membrane; with an increasing current, the contribution of the HPO42- ions grew, and when the current was about 2.5 ilimLev (ilimLev was the theoretical limiting current density), the PO43- ions started to carry the charge through the membrane. However, in the feed solution, the pH was 4.6 and only H2PO4- ions were present. When H2PO4- ions entered the membrane, a part of them transformed into doubly and triply charged anions; the H+ ions were released in this transformation and returned to the depleted diffusion layer. Thus, the phosphorus total flux, jP (equal to the sum of the fluxes of all phosphorus-bearing species) was limited by the H2PO4- transport from the bulk of feed solution to the membrane surface. The value of jP was close to ilimLev/F (F is the Faraday constant). A slight excess of jP over ilimLev/F was observed, which is due to the electroconvection and exaltation effects. The visualization showed that electroconvection in the studied systems was essentially weaker than in systems with strong electrolytes, such as NaCl.

Extraction, formulation and characterization of an in vitro and ex-vivo evaluation of Thymus serpyllum L. (Thymus oil) from topical preparations using dialysis cellulose membrane and natural rabbit skin

Herbal remedies like the Thymus serpyllum L. is useful in traditional medicine for the treatment of many diseases especially congestion, and bronchitis. The purpose of this study was to formulate a micro-emulsion, a gel and an ointment containing the plant hydro distilled thymus oil extracted from Thymus serpyllum L. collected from Ziarat, Balochistan. The prepared formulations were subjected to in-vitro and ex vivo study release, High performance Liquid Chromatography (HPLC), Thin Layer Chromatography (TLC), to justify their suitability for topical use. The in-vitro and ex-Vivo release was studied using Franz Cells and using two different kinds of membrane synthetic dialysis cellulose membrane and natural rabbit skin and the amount of drug released was determined by HPLC at λ 274nm. The three formulations result obtained through dialysis cellulose membrane showed the faster release than the natural rabbit skin. However, the micro-emulsion, gel formulation showed the same release except ointment. The release from the above mentioned formulation can be arranged in the following descending order. micro-emulsion > Gel > Ointment. The best fit of release kinetics was achieved by Krosmeyer- Peppas, the TLC and HPLC identifies the Thymol, isolation and quantification of the marker. This study demonstrates that it is necessary to assess the impact of release and permeability pattern of different formulations. In vitro and ex-vivo diffusion cell experiments can be utilized to develop formulations of traditional medicines identifies.

Assessment of free testosterone concentration

Testosterone (T) is strongly bound to sex hormone binding globulin and measurement of free T may be more appropriate than measuring total serum T, according to the free hormone theory. This view remains controversial and it has its detractors who claim that little extra benefit is gained than simply measuring total T, but it is endorsed by recent clinical practice guidelines for investigation of androgen disorders in both men and women. Free T measurement is very challenging. The gold standard equilibrium dialysis methods are too complex for use in routine clinical laboratories, assays are not harmonized and consequently there are no common reference intervals to aid result interpretation. The algorithms derived for calculating free T are inaccurate because they were founded on faulty models of testosterone binding to SHBG, however they can still give clinically useful results. To negate the effects of differences in binding protein constants, some equations for free T have been derived from accurate measurement of testosterone in large population studies, however a criticism is that the equations may not hold true in different patient populations. The free androgen index is not recommended for use in men because of inaccuracy at extremes of SHBG concentration, and in women it can also give inaccurate results when SHBG concentrations are low. If the free hormone hypothesis is to be believed, then calculated free testosterone may offer the best way forward but better equations are needed to improve accuracy and these should be derived from detailed knowledge of testosterone binding to SHBG. There is still much work to be done to improve harmonization of T and SHBG assays between laboratories because these can have a profound effect on the equations used to calculate free testosterone.

Iontophoretic delivery of transdermal patches containi

The present clinical trial investigates the sustaining anesthetic effect of Ropivacaine when administered as epidural injection followed by transdermal patch with and without Reverse electrodialysis (RED) system in order to maintain anesthesia in children. It also focuses on rate of release of drug in-vitro when administered with RED system. The transdermal patch of Ropivacaine was prepared using evaporation technique enclosing 25 mg of Local anesthetic Ropivacaine. Thus prepared patches were evaluated for physical parameters like folding endurance, tensile strength, in vitro drug release etc. The thicknesses of the patches were in the range of 0.02 ±0.006 to 0.04 ± 0.007 mm with 95.79 ±1.85 to 97.45±0.07 % drug content. The average weight and tensile strength was found to be 0.15±0.2 to 0.17±0.18 gm and 0.42±0.006 to 0.58±0.002 kg/cm2. The folding endurance of the patches was in range of 155.21 ±0.2 to 167± 0.29 and content of moisture was 1.43±0.23 % to 2.97±0.23 %. The formulation shows In - vitro release in Phosphate buffer pH 7.4 as 55.56 % to 89.23 ± 0.24 % in 24 hr with reverse electrodialysis system attached and 43.76 % to 81.23 ± 0.14 % in 24 hr without reverse electrodialysis system. The children of different age groups, different body weight with no premedication of anesthetic of analgesic were selected as subjects with written informed consent and divided into two groups depending upon RED system to be attached or not. The patches with and without RED system were attached to forearm of subjects and trial is run. The results obtained showed that patch when attached with reverse electrodialysis system showed greater potential for thermal threshold, lowering of cool sensation and depth of pain. Keywords: Child Anesthesia, Iontophoresis, Reverse Electrodialysis ,Ropivacaine, Transdermal Patch.

Positive Impact of Pulsed Electric Field on Lactic Acid Removal, Demineralization and Membrane Scaling during Acid Whey Electrodialysis

The drying of acid whey is hindered by its high mineral and organic acid contents, and their removal is performed industrially through expensive and environmentally impacting serial processes. Previous works demonstrated the ability to remove these elements by electrodialysis alone but with a major concern-membrane scaling. In this study, two conditions of pulsed electric field (PEF) were tested and compared to conventional DC current condition to evaluate the potential of PEF to mitigate membrane scaling and to affect lactic acid and salt removals. The application of a PEF 25 s/25 s pulse/pause combination at an initial under-limiting current density allowed for decreasing the amount of scaling, the final system electrical resistance by 32%, and the relative energy consumption up to 33%. The use of pulsed current also enabled better lactic acid removal than the DC condition by 10% and 16% for PEF 50 s/10 s and 25 s/25 s, respectively. These results would be due to two mechanisms: (1) the mitigation of concentration polarization phenomenon and (2) the rinsing of the membranes during the pause periods. To the best of our knowledge, this was the first time that PEF current conditions were used on acid whey to both demineralize and deacidify it.

Pre-dialysis acute care hospitalizations and clinical outcomes in dialysis patients

BACKGROUND

Patients with chronic kidney disease (CKD), a precursor of end stage renal disease (ESRD), face an increasing burden of hospitalizations. Although mortality on dialysis is highest during the first year, the impact of pre-dialysis acute hospitalizations on clinical outcomes in dialysis patients remains unknown.

METHODS

We evaluated 170,897 adult patients who initiated dialysis between 1/1/2010 and 12/31/2014 with linked Medicare claims from the United States Renal Data System. Using logistic regression models, we examined the association of 2-year pre-dialysis hospitalization on the primary outcome of 1-year all-cause mortality. Secondary outcomes included 90-day mortality, type of initial dialysis modality and type of vascular access at hemodialysis initiation.

RESULTS

Mean age was 72.7 ± 11.0 years. In the study sample, 76.0% of patients had at least one pre-dialysis hospitalization. Compared to patients with no pre-dialysis hospitalization, the adjusted 1-year mortality was higher with pre-dialysis cardiovascular related hospitalization (odds ratio [OR], 1.63; 95% confidence interval [CI], 1.57-1.68), infection related hospitalization (OR, 1.51; CI, 1.45-1.57), both cardiovascular and infection hospitalization (OR, 1.91; CI, 1.83-1.99), and neither-cardiovascular nor-infection hospitalization (OR, 1.23; CI, 1.19-1.27). Additionally, the adjusted odds of hemodialysis vs. peritoneal dialysis as the initial dialysis modality were higher, whereas adjusted odds to initiate hemodialysis with an arteriovenous access vs. central venous catheter were lower in patients with any type of hospitalization.

CONCLUSION

Pre-dialysis hospitalization is an independent predictor of 1-year mortality in dialysis patients. Reducing the risk of pre-dialysis hospitalization may provide opportunities to improve quality of care in ESRD.

Profiled Ion Exchange Membranes: A Comprehensible Review

Profiled membranes (also known as corrugated membranes, micro-structured membranes, patterned membranes, membranes with designed topography or notched membranes) are gaining increasing academic and industrial attention and recognition as a viable alternative to flat membranes. So far, profiled ion exchange membranes have shown to significantly improve the performance of reverse electrodialysis (RED), and particularly, electrodialysis (ED) by eliminating the spacer shadow effect and by inducing hydrodynamic changes, leading to ion transport rate enhancement. The beneficial effects of profiled ion exchange membranes are strongly dependent on the shape of their profiles (corrugations/patterns) as well as on the flow rate and salts’ concentration in the feed streams. The enormous degree of freedom to create new profile geometries offers an exciting opportunity to improve even more their performance. Additionally, the advent of new manufacturing methods in the membrane field, such as 3D printing, is anticipated to allow a faster and an easier way to create profiled membranes with different and complex geometries.

Analysis of capacitive and electrodialytic contributions to water desalination by flow-electrode CDI

While flow-electrode capacitive deionization (FCDI) is a potential alternative to brackish and/or sea water desalination, there is limited understanding of both the fate of ions following migration across the ion exchange membranes and the mechanisms responsible for ion separation. In this study, we investigate the desalting performance of an FCDI system operated over a range of conditions. Results show that although ion transport as a result of electrodialysis is inevitable in FCDI (and is principally responsible for pH excursion in the flow electrode), the use of high carbon content ensures that a high proportion of the charge and counterions are retained in the electrical double layers of the flowing carbon particles, even at high charging voltages (e.g., 2.0 V) during the deionization process. Estimation of the portions of sodium and chloride ions adsorbed in the flow electrode after migration through the membranes suggests that the ongoing capacitive adsorption exhibits asymmetric behavior with the anodic particles demonstrating better affinity for Cl^- (than the cathodic particles for Na⁺) during electrosorption. These findings provide an explanation for the change in electrode properties that are observed under imperfect adsorption scenarios and provide insight into aspects of the design and operation of flow electrode pairs that is critical to achieving effective desalination by FCDI.

Refinery and concentration of nutrients from urine with electrodialysis enabled by upstream precipitation and nitrification

Human urine is a valuable resource for nutrient recovery, given its high levels of nitrogen, phosphorus and potassium, but the compositional complexity of urine presents a challenge for an energy-efficient concentration and refinery of nutrients. In this study, a pilot installation combining precipitation, nitrification and electrodialysis (ED), designed for one person equivalent (1.2 L_urine d^-1), was continuously operated for ∼7 months. First, NaOH addition yielded calcium and magnesium precipitation, preventing scaling in ED. Second, a moving bed biofilm reactor oxidized organics, preventing downstream biofouling, and yielded complete nitrification on diluted urine (20-40%, i.e. dilution factors 5 and 2.5) at an average loading rate of 215 mg N L^-1 d^-1. Batch tests demonstrated the halotolerance of the nitrifying community, with nitrification rates not affected up to an electrical conductivity of 40 mS cm^-1 and gradually decreasing, yet ongoing, activity up to 96 mS cm^-1 at 18% of the maximum rate. Next-generation 16S rRNA gene amplicon sequencing revealed that switching from a synthetic influent to real urine induced a profound shift in microbial community and that the AOB community was dominated by halophilic species closely related to Nitrosomonas aestuarii and Nitrosomonas marina. Third, nitrate, phosphate and potassium in the filtered (0.1 μm) bioreactor effluent were concentrated by factors 4.3, 2.6 and 4.6, respectively, with ED. Doubling the urine concentration from 20% to 40% further increased the ED recovery efficiency by ∼10%. Batch experiments at pH 6, 7 and 8 indicated a more efficient phosphate transport to the concentrate at pH 7. The newly proposed three-stage strategy opens up opportunities for energy- and chemical-efficient nutrient recovery from urine. Precipitation and nitrification enabled the long-term continuous operation of ED on fresh urine requiring minimal maintenance, which has, to the best of our knowledge, never been achieved before.

The interaction between N-terminal pro-brain natriuretic peptide and fluid status in adverse clinical outcomes of late stages of chronic kidney disease

Introduction

Fluid overload is one of the major characteristics and complications in patients with chronic kidney disease (CKD). N-terminal pro-brain natriuretic peptide (NT-proBNP) is related to fluid status and fluid distribution. The aim of this study is to investigate the interaction between NT-proBNP and fluid status in adverse clinical outcomes of late stages of CKD.

Methods

We enrolled 239 patients with CKD stages 4–5 from January 2011 to December 2011 and followed up until June 2017. Fluid status was presented as hydration status (HS) value measured by body composition monitor, while HS>7% was defined as fluid overload. Clinical outcomes included renal outcomes (commencing dialysis and estimated glomerular filtration rate decline>3 ml/min/1.73 m²/year), all-cause mortality and major adverse cardiovascular events (MACEs).

Results

During a mean follow-up of 3.3±2.0 years, 129(54.7%) patients commenced dialysis, 88(37.3%) patients presented rapid renal function decline, and 48(20.3%) had MACEs or died. All patients were stratified by HS of 7% and the median of plasma NT-proBNP. The adjusted risks for commencing dialysis was significantly higher in patients with high plasma NT-proBNP and HS>7% compared to those with low plasma NT-proBNP and HS≦7%. There was a significant interaction between plasma NT-proBNP and HS in commencing dialysis (P-interaction = 0.047). Besides, patients with high plasma NT-proBNP and HS>7% had greater risks for MACEs or all-cause mortality than others with either high plasma NT-proBNP or HS>7%.

Conclusion

NT-proBNP and fluid overload might have a synergistic association of adverse clinical outcomes in patients with late stages of CKD.

Brewery wastewater treatment using MBR coupled with nanofiltration or electrodialysis: biomass acclimation and treatment efficiency

Breweries release significant amounts of wastewater loaded with various organic and mineral materials. Prior studies of membrane bioreactor (MBR) wastewater treatment have been conducted with very little interest granted to the conditions of biomass acclimation. This study displays biomass behavior during brewery wastewater treatment by an aerobic MBR. In addition, nanofiltration and electrodialysis have been studied as potential post-treatment to decrease mineral concentrations and permit further water reuse for agriculture. An anoxic/aerobic laboratory MBR, associated with a flat sulfonated polyether membrane was used for synthetic brewery wastewater treatment. Biomass acclimation was performed using a feeding substrate. Organic concentrations in the MBR influent varied from 700 mg COD/L to 10,600 mg COD/L (COD: chemical oxygen demand) for 110 days. The results indicate a good acclimation to effluent with high salts and organic matter loads. Steady evolution of biomass concentration and activities was achieved after 90 days of operation. A reduction of COD of around 95% was obtained with MBR and up to 99% with nanofiltration post-treatment for the reconstructed brewery effluent with an organic loading rate of 7 g COD/L·d and a solid and hydraulic retention time of 30 days and 36 hours. A good reduction of the salt content was also recorded primarily with the nanofiltration and electrodialysis processes.

Nutrient recovery from wastewater through pilot scale electrodialysis

Nutrient recovery performance utilising an electrodialysis (ED) process was quantified in a 30-cell pair pilot reactor with a 7.2 m² effective membrane area, utilising domestic anaerobic digester supernatant, which had been passed through a centrifuge as a feed source (centrate). A concentrated product (NH₄-N 7100 ± 300 mg/L and K 2490 ± 40 mg/L) could be achieved by concentrating nutrient ions from the centrate wastewater dilute feed stream to the product stream using the ED process. The average total current efficiency for all major cations over the experimental period was 76 ± 2% (NH₄-N transport 40%, K transport 14%). The electrode power consumption was 4.9 ± 1.5 kWh/kgN, averaged across the three replicate trials. This value is lower than competing technologies for NH₄-N removal and production, and far lower than previous ED lab trials, demonstrating the importance of pilot testing. No significant variation in starting flux densities and cell resistance voltage for subsequent replicate treatments indicated effective cleaning procedures and operational sustainability at treatment durations of several days. This study demonstrates that ED is an economically promising technology for the recovery of nutrients from wastewater.

Removal of stabilizers from human serum albumin by adsorbents and dialysis used in blood purification

INTRODUCTION

Human serum albumin (HSA) is a monomeric multi-domain protein that possesses an extraordinary binding capacity. It plays an important role in storing and transporting endogenous substances, metabolites, and drugs throughout the human circulatory system. Clinically, HSA is used to treat a variety of diseases such as hypovolemia, shock, burns, hemorrhage, and trauma in critically ill patients. Pharmaceutical-grade HSA contains the stabilizers sodium caprylate and N-acetyltryptophanate to protect the protein from oxidative stress and to stabilize it for heat treatment which is applied for virus inactivation.

MATERIAL AND METHODS

The aim of this study was to determine if the two stabilizers can be depleted by adsorbent techniques. Several, adsorbents, some of them are in clinical use, were tested in batch and in a dynamic setup for their ability to remove the stabilizers. Furthermore, the removal of the stabilizers was tested using a pediatric high flux dialyzer.

RESULTS

The outcome of this study shows that activated charcoal based adsorbents are more effective in removal of N-acetylthryptophanate, whereas polystyrene based adsorbents are better for the removal of caprylate from HSA solutions. An adsorbent cartridge which contains a mix of activated charcoal and polystyrene based material could be used to remove both stabilizers effectively. After 4 hours treatment with a high flux dialyzer, N-acetyltryptophanate was totally removed whereas 20% of caprylate remained in the HSA solution.

Reverse electrodialysis performed at pilot plant scale: Evaluation of redox processes and simultaneous generation of electric energy and treatment of wastewater

This paper describes the experimental campaign carried out with a reverse electrodialysis (RED) demonstration plant (Marsala, Italy) with the main aims of: (i) evaluating the effect of various operating parameters, including the redox processes, on the system performances; (ii) using the plant for the simultaneous generation of electric energy and treatment of wastewater. The prototype (44 × 44 cm², 500 cell pairs) was tested using both real (brackish water and brine) and artificial solutions. Tests with two different electrode rinse solutions (with or without iron redox couples) were performed. In agreement with the data obtained in the laboratory, the presence of iron ions contributes positively to the power production. The effect of flow rates in the electrode and saline compartments, as well as aging of the electrode rinse solution was also investigated. The possibility to remove an organic pollutant (the azoic dye Acid Orange 7) from the electrode solution was tested, obtaining a very fast and total removal of the pollutant. This experimental campaign represents the first demonstration in a real environment of the abilities of a RED plant to treat wastewater, thus giving useful indications for the spreading of RED technology in the near future.

CO2 saturated water as two-phase flow for fouling control in reverse electrodialysis

When natural feed waters are used in the operation of a reverse electrodialysis (RED) stack, severe fouling on the ion exchange membranes and spacers occurs. Fouling of the RED stack has a strong influence on the gross power density output; which can decrease up to 50%. Moreover, an increase in the pressure loss occurs between the feed water inlet and outlet, increasing the pumping energy and thus decreasing the net power density that can be obtained. In this work, we extensively investigated the use of CO₂ saturated water as two-phase flow cleaning for fouling mitigation in RED using natural feed waters. Experiments were performed in the REDstack research facility located at the Afsluitdijk (the Netherlands) using natural feed waters for a period of 60 days. Two different gas combinations were experimentally investigated, water/air sparging and water/CO₂ (saturated) injection. Air is an inert gas mixture and induces air sparging in the stack. In the case of CO₂, nucleation, i.e. the spontaneous formation of bubbles, occurs at the spacer filaments due to depressurization of CO₂ saturated water, inducing cleaning. Results showed that stacks equipped with CO₂ saturated water can produce an average net power density of 0.18 W/m² under real fouling conditions with minimal pre-treatment and at a low outside temperature of only 8 °C, whereas the stacks equipped with air sparging could only produce an average net power density of 0.04 W/m². Electrochemical impedance spectroscopy measurements showed that the stacks equipped with air sparging increased in stack resistance due to the presence of stagnant bubbles remaining in the stack after every air injection. Furthermore, the introduction of CO₂ gas in the feed water introduces a pH decrease in the system (carbonated solution) adding an additional cleaning effect in the system, thus avoiding the use of environmentally unwanted cleaning chemicals.

Phenolic compounds, antioxidant potential and antiproliferative potential of 10 common edible flowers from China assessed using a simulated in vitro digestion-dialysis process combined with cellular assays

BACKGROUND

Phenolic compounds could be sensitive to digestive conditions, thus a simulated in vitro digestion-dialysis process and cellular assays was used to determine phenolic compounds and antioxidant and antiproliferative potentials of 10 common edible flowers from China and their functional components.

RESULTS

Gallic acid, ferulic acid, and rutin were widely present in these flowers, which demonstrated various antioxidant capacities (DPPH, ABTS, FRAP and CAA values) and antiproliferative potentials measured by the MTT method. Rosa rugosa, Paeonia suffruticosa and Osmanthus fragrans exhibited the best antioxidant and antiproliferative potentials against HepG2, A549 and SGC-7901 cell lines, except that Osmanthus fragrans was not the best against SGC-7901 cells. The in vitro digestion-dialysis process decreased the antioxidant potential by 33.95-90.72% and the antiproliferative potential by 13.22-87.15%. Following the in vitro digestion-dialysis process, phenolics were probably responsible for antioxidant (R² = 0.794-0.924, P < 0.01) and antiproliferative (R² = 0.408-0.623, P < 0.05) potential. Moreover, gallic acid may be responsible for the antioxidant potential of seven flowers rich in edible flowers.

CONCLUSION

The antioxidant and antiproliferative potential of 10 edible flowers revealed a clear decrease after digestion and dialysis along with the reduction of phenolics. Nevertheless, they still had considerable antioxidant and antiproliferative potential, which merited further investigation in in vivo studies. © 2017 Society of Chemical Industry.

Recovery of nutrients from digested sludge as struvite with a combination process of acid hydrolysis and Donnan dialysis

In this study, the effects of the combination of acid hydrolysis and Donnan dialysis on the high-quality struvite production from digested sewage sludge were examined. The Box-Behnken design was applied in the hydrolysis using oxalic acid for the optimization of the conditions that affect the nutrients and metal release from digested sludge. An optimal condition was obtained at oxalic acid 0.5 M, acid/sludge ratio (mL/g) 10/1, and reaction time 60 min. The separation of the metals from hydrolyzed sludge liquid was carried out with the Donnan dialysis using a Nafion 117 cation exchange membrane. At the end of the 4 hours of operating time, the recovery values for Zn, K, Na, Mg, Fe, and Al were obtained as 67.9%, 62.1%, 57.6%, 39.4%, 5.3%, and 2.5%, respectively. The produced struvite meets the legal limits for fertilizer use in terms of Cd, Cu, Ni, Pb, Zn, Hg, and Cr content specified by Turkish regulations. A high Ca/Mg molar ratio and the presence of K, Na, and Al affected the efficiency of struvite crystallization. The use of oxalic acid resulted in low Ca release, and the metal ions that affect struvite purity were eliminated using Donnan dialysis.

Effect of dialysis modality on frailty phenotype, disability, and health-related quality of life in maintenance dialysis patients

Background

Health-related quality of life (HRQoL) surveys are needed to evaluate regional and ethnic specificies. The aim of the present study was to evaluate the differences in HRQoL, frailty, and disability according to dialysis modality in the Korean population.

Patients and methods

We enrolled relatively stable maintenance dialysis patients. A total of 1,616 patients were recruited into our study. The demographic and laboratory data collected at enrollment included age, sex, comorbidities, frailty, disability, and HRQoL scales.

Results

A total of 1,250 and 366 participants underwent hemodialysis (HD) and peritoneal dialysis (PD), respectively. The numbers of participants with pre-frailty and frailty were 578 (46.2%) and 422 (33.8%) in HD patients, and 165 (45.1%) and 137 (37.4%) in PD patients, respectively (P = 0.349). Participants with a disability included 195 (15.6%) HD patients and 109 (29.8%) PD patients (P < 0.001). On multivariate analysis, the mean physical component scale (PCS) and mental component scale (MCS), symptom/problems, and sleep scores were higher in HD patients than in PD patients. Cox regression analyses showed that an increased PCS in both HD and PD patients was positively associated with patient survival and first hospitalization–free survival. An increased MCS in both HD and PD patients was positively associated with first hospitalization–free survival only.

Conclusion

There was no significant difference in frailty between patients treated with the two dialysis modalities; however, disability was more common in PD patients than in HD patients. The MCS and PCS were more favorable in HD patients than in PD patients. Symptom/problems, sleep, quality of social interaction, and social support were more favorable in HD patients than in PD patients; however, patient satisfaction and dialysis staff encouragement were more favorable in PD patients than in HD patients.

Effects on breathing of agonists to μ-opioid or GABAA receptors dialyzed into the ventral respiratory column of awake and sleeping goats

Pulmonary ventilation (V̇I) in awake and sleeping goats does not change when antagonists to several excitatory G protein-coupled receptors are dialyzed unilaterally into the ventral respiratory column (VRC). Concomitant changes in excitatory neuromodulators in the effluent mock cerebral spinal fluid (mCSF) suggest neuromodulatory compensation. Herein, we studied neuromodulatory compensation during dialysis of agonists to inhibitory G protein-coupled or ionotropic receptors into the VRC. Microtubules were implanted into the VRC of goats for dialysis of mCSF mixed with agonists to either μ-opioid (DAMGO) or GABAA (muscimol) receptors. We found: (1) V̇I decreased during unilateral but increased during bilateral dialysis of DAMGO, (2) dialyses of DAMGO destabilized breathing, (3) unilateral dialysis of muscimol increased V̇I, and (4) dialysis of DAMGO decreased GABA in the effluent mCSF. We conclude: (1) neuromodulatory compensation can occur during altered inhibitory neuromodulator receptor activity, and (2) the mechanism of compensation differs between G protein-coupled excitatory and inhibitory receptors and between G protein-coupled and inotropic inhibitory receptors.

Investigation of the interaction between berberine and nucleosomes in solution: Spectroscopic and equilibrium dialysis approach

Berberine is a natural plant alkaloid with high pharmacological potential. Although its interaction with free DNA has been the subject of several reports, to date there is no work concerning the effect of berberine on nucleoprotein structure of DNA, the nucleosomes. The present study focuses on the binding affinity of berberine to nucleosomes and histone H1 employing various spectroscopic techniques, fluorescence, circular dichroism, thermal denaturation as well as equilibrium dialysis. The results showed that the binding of berberine to nucleosomes is positive cooperative with Ka=5.57×10³M^-1. Berberine quenched with the chromophores of protein moiety of nucleosomes and reduced fluorescence emission intensity at 335nm with Ksv value of 0.135. Binding of berberine to nucleosomes decreased the absorbance at 210 and 260nm, produced hypochromicity in thermal denaturation profiles and its affinity to nucleoprotein structure of nucleosomes was much higher than to free DNA. Berberine also exhibited high affinity to histone H1 in solution and the binding was positive cooperative with. Ka=3.61×10³M^-1. Moreover berberine decreased fluorescence emission intensity of H1 by quenching with tyrosine residue in its globular core domain. The circular dichroism profiles demonstrated that the binding of drug induced secondary structural changes in both DNA stacking and histone H1. It is concluded that berberine is genotoxic drug, interacts with nucleosomes and in this process histone H1 is involved to exert its anticancer activity.

Drawbacks of Dialysis Procedures for Removal of EDTA

Ethylenediaminetetraacetic acid (EDTA) is a chelating agent commonly used in protein purification, both to eliminate contaminating divalent cations and to inhibit protease activity. For a number of subsequent applications EDTA needs to be exhaustively removed. Most purification methods rely in extensive dialysis and/or gel filtration in order to exchange or remove protein buffer components, including metal chelators. We report here that dialysis protocols, even as extensive as those typically employed for protein refolding, may not effectively remove EDTA, which is reduced only by approximately two-fold and it also persists after spin-column gel filtration, as determined by NMR and by colorimetric methods. Remarkably, the most efficient removal was achieved by ultrafiltration, after which EDTA became virtually undetectable. These results highlight a potentially widespread source of experimental variability affecting free divalent cation concentrations in protein applications.

Recovery of ionic liquid via a hybrid methodology of electrodialysis with ultrafiltration after biomass pretreatment

Hybrid membrane-based methodology of electrodialysis (ED) with ultrafiltration (UF) was employed to recover the IL BmimBr (1-Butyl-3-methylimidazolium bromide) after biomass fractionation. Ultrafiltration was used to remove the residual lignin in IL solutions. Influence of molecular weight interception of UF treatment, initial IL concentration in dilute section, applied voltage and flow rate in each section of ED module were studied in detail. In this study, the highest overall IL recovery ratio reached 75.2% and the current efficiency of ED process approached 79.1%. Besides, the highest IL recovery performance of specific energy consumption was about 514.1g/kw·h. Insight gained from this study suggests a potential methodology for IL recovery after the pretreatment process for biomass.

Bioethanol production from deacetylated yellow poplar pretreated with oxalic acid recovered through electrodialysis

Electrodialysis (ED) was used to develop a multistage oxalic acid recovery and pretreatment system to produce ethanol from deacetylated yellow poplar. Pretreatment of the biomass was performed at 150°C for 42 min using 0.16 M oxalic acid. The efficiency of oxalic acid recovery from the hydrolysate reached up to 92.32% in all the stages. Ethanol production and ethanol yield of ED-treated hydrolysate in each stage showed a uniform pattern ranging from 6.81 g/L to 7.21 g/L and 0.40 g/g to 0.43 g/g, respectively. The results showed that efficiency of ethanol production increased when deacetylated biomass and ED process was used. Ethanol yield from the pretreated biomass using simultaneous saccharification and fermentation (SSF) was in the range of 80.59-83.36% in all the stages. The structural characterization of the pretreated biomass at each stage was investigated and structural changes were not significantly different among the various pretreated biomass.

Mitigation of Salinity Buildup and Recovery of Wasted Salts in a Hybrid Osmotic Membrane Bioreactor-Electrodialysis System

The osmotic membrane bioreactor (OMBR) is an emerging technology that uses water osmosis to accomplish separation of biomass from the treated effluent; however, accumulation of salts in the wastewater due to water flux and loss of draw solute because of reverse salt flux seriously hinder OMBR development. In this study, a hybrid OMBR-electrodialysis (ED) system was proposed and investigated to alleviate the salinity buildup. The use of an ED (3 V applied) could maintain a relatively low conductivity of 8 mS cm(-1) in the feed solution, which allowed the OMBR to operate for 24 days, about 6 times longer than a conventional OMBR without a functional ED. It was found that the higher the voltage applied to the ED, the smaller area of ion-exchange membrane was needed for salt separation. The salts recovered by the ED were successfully reused as a draw solute in the OMBR. At an energy consumption of 1.88-4.01 kWh m(-3), the hybrid OMBR-ED system could achieve a stable water flux of about 6.23 L m(-2) h(-1) and an efficient waste salt recovery of 1.26 kg m(-3). The hybrid OMBR-ED system could be potentially more advantageous in terms of less waste saline water discharge and salt recovery compared with a combined OMBR and reverse osmosis system. It also offers potential advantages over the conventional OMBR+post ED treatment in higher water flux and less wastewater discharge.

Removal and recovery of inhibitory volatile fatty acids from mixed acid fermentations by conventional electrodialysis

Hydrogen production during dark fermentation is inhibited by the co-production of volatile fatty acids (VFAs) such as acetic and n-butyric acid. In this study, the effectiveness of conventional electrodialysis (CED) in reducing VFA concentrations in model solutions and hydrogen fermentation broths is evaluated. This is the first time CED has been reported to remove VFAs from hydrogen fermentation broths. During 60 min of operation CED removed up to 99% of VFAs from model solutions, sucrose-fed and grass-fed hydrogen fermentation broths, containing up to 1200 mg l(-1) each of acetic acid, propionic acid, i-butyric acid, n-butyric acid, i-valeric acid, and n-valeric acid. CED's ability to remove VFAs from hydrogen fermentation broths suggests that this technology is capable of improving hydrogen yields from dark fermentation.

Morphologically Aligned Cation-Exchange Membranes by a Pulsed Electric Field for Reverse Electrodialysis

A low-resistance ion-exchange membrane is essential to achieve the high-performance energy conversion or storage systems. The formation methods for low-resistance membranes are various; one of the methods is the ion channel alignment of an ion-exchange membrane under a direct current (DC) electric field. In this study, we suggest a more effective alignment method than the process with the DC electric field. First, an ion-exchange membrane was prepared under a pulsed electric field [alternating current (AC) mode] to enhance the effectiveness of the alignment. The membrane properties and the performance in reverse electrodialysis (RED) were then examined to assess the membrane resistance and ion selectivity. The results show that the membrane electrical resistance (MER) had a lower value of 0.86 Ω cm(2) for the AC membrane than 2.13 Ω cm(2) observed for the DC membrane and 4.30 Ω cm(2) observed for the pristine membrane. Furthermore, RED achieved 1.34 W/m(2) of maximum power density for the AC membrane, whereas that for the DC membrane was found to be 1.14 W/m(2) [a RED stack assembled with CMX, used as a commercial cation-exchange membrane (CEM), showed 1.07 W/m(2)]. Thereby, the novel preparation process for a remarkable low-resistance membrane with high ion selectivity was demonstrated.

Effect of Nocturnal Dialysis on Prognosis in Adult Patients: A Review of the Literature

Compared to conventional hemodialysis dialysis, nocturnal hemodialysis represents a more effective modality for receiving hemodialysis and has been associated with a 25% reduction in risk of death and improved quality of life. This article identifies the evidence about the mortality and morbidity risk for patients undergoing conventional hemodialysis vs. nocturnal hemodialysis.