Sorbent hemoperfusion in end-stage renal disease: an in-depth review

The excessive mortality in dialysis patients has rekindled interest in research of adsorbent removal of nontraditional uremic toxins. Middle-molecular-weight substances, predominantly small proteins, have been correlated with specific uremic syndromes and implicated in the uremic state. New developments in polymer technology and carbon pyrrolization techniques have produced sorbents possessing mesopores of sufficient size to trap middle-molecular-weight substances. Clinical application of hemoperfusion devices containing these sorbents is early in its development. Studies related to hemoperfusion in uremia are discussed in detail.