Removal of plasma porphyrins with high-flux hemodialysis in porphyria cutanea tarda associated with end-stage renal disease

Richard W. Carson, Earl J. Dunnigan, Thomas D. DuBose, Douglas E. Goeger, Karl Anderson

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Plasma porphyrin levels are markedly increased in patients with porphyria cutanea tarda (PCT) associated with end-stage renal disease. Conventional hemodialysis (CHD) with lower blood flow rates (<250 mL/min) and cuprophan or cellulose acetate membranes is ineffective in removing significant amounts of porphyrins in this condition. Changes in plasma porphyrin levels and porphyrin clearances during hemodialysis with higher blood flow rates and morepermeable, high-efficiency cellulose acetate and high-flux polysulfone dialyzers were evaluated in a chronic hemodialysis patient with PCT and markedly elevated plasma porphyrins. The polysulfone membrane achieved significantly better fractional porphyrin removal (P= 0.02) and porphyrin clearances (P< 0.01) than did the high-efficiency cellulose acetate membrane. After conversion from maintenance CHD with a standard cellulose acetate dialyzer to a 4-wk period of high-flux hemodialysis (HFHD) with a polysulfone dialyzer, predialysis plasma porphyrins fell by 37%. After returning to CHD, plasma porphyrins returned to the higher prestudy levels. These observations suggest that HFHD with more permeable membranes and higher blood flow rates removes porphyrins more effectively than does CHD. HFHD may be a useful adjunct to other measures used in treating dialysis patients with PCT.

Original languageEnglish (US)
Pages (from-to)1445-1450
Number of pages6
JournalJournal of the American Society of Nephrology
Volume2
Issue number9
StatePublished - Mar 1992

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Porphyria Cutanea Tarda
Porphyrins
Chronic Kidney Failure
Renal Dialysis
Membranes
Dialysis
Maintenance

Keywords

  • High-flux hemodialysis
  • Porphyria cutanea tarda
  • Porphyrins

ASJC Scopus subject areas

  • Nephrology

Cite this

Removal of plasma porphyrins with high-flux hemodialysis in porphyria cutanea tarda associated with end-stage renal disease. / Carson, Richard W.; Dunnigan, Earl J.; DuBose, Thomas D.; Goeger, Douglas E.; Anderson, Karl.

In: Journal of the American Society of Nephrology, Vol. 2, No. 9, 03.1992, p. 1445-1450.

Research output: Contribution to journalArticle

Carson, Richard W. ; Dunnigan, Earl J. ; DuBose, Thomas D. ; Goeger, Douglas E. ; Anderson, Karl. / Removal of plasma porphyrins with high-flux hemodialysis in porphyria cutanea tarda associated with end-stage renal disease. In: Journal of the American Society of Nephrology. 1992 ; Vol. 2, No. 9. pp. 1445-1450.
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