Removal of aluminoxamine and ferrioxamine by charcoal hemoperfusion and hemodialysis

Abstract

We studied the removal of aluminoxamine (AlO) and ferrioxamine (FO) by (i) hemoperfusion/hemodialysis using an AluKart(R) in combination with either a Cuprophan(R) F-120 or a Hemophan(R) FH-160 membrane, or (ii) hemodialysis with a high-flux F-60 polysulfone membrane. The same six dialysis patients underwent in a random order dialysis by the three set-ups after i.v. infusion of 30 mg/kg of desferrioxamine (DFO) during the last half an hour of the preceding dialysis session. The mean ± SD plasma AlO and FO clearances of the AluKart(R) combined with either a F-120 or FH-160 membrane were 194.3 ± 25.8 ml/min (AlO) and 164.2 ± 41.3 ml (FO) at the start of dialysis declining to respectively 76.6 ± 27.3 and 68.5 ± 42.6 ml/min at the end of dialysis. With a high-flux dialysis membrane the intra-dialytic plasma clearance remained constant at 81.5 ± 6.8 ml/min for AlO and 60.0 ± 2.8 ml/min for FO. In the presence of an AluKart(R) combined with a FH-160 up to 84 ± 27% and 84 ± 19% of the available AlO and FO could be removed during a four-hour hemoperfusion/hemodialysis session. During the first hour of dialysis, respectively 59 and 58% of the total amount of AlO and FO extracted by the AluKart(R) was removed compared to only 9 and 16% during the last hour. We conclude that the combined use of hemoperfusion/hemodialysis is highly effective followed closely by a high-flux F-60 membrane in the removal of AlO and FO and in combination with low (5 to 10 mg/kg) DFO doses, may reduce the risk for side effects that have been associated with these compounds.