Characterization and extracorporeal application of a new phosphate-binding agent.

A new phosphate-binding agent which does not cause any severe side effects in vivo was developed by modifying a crosslinked dextran with polynuclear iron(III)oxide-hydroxide. Its particle size ranges from 150 to 300 microns, and the iron content was about 18% by dry weight. The oxidation state of iron was characterized by ESCA and Mössbauer spectroscopy. The maximum phosphate binding capacity of the iron(III)oxide-hydroxide-modified dextran was determined with respect to aqueous phosphate solutions, human serum and whole blood. The effects on whole blood count, haemolysis, protein concentration and enzyme activities were examined. In addition, the influence of phosphate concentration, pH and temperature on the phosphate uptake of the material was determined. The results show that this new adsorbent might provide an alternative to conventional phosphate-binding agents. This paper also describes the first experiments on the therapeutic application of the material in an extracorporeal blood perfusion system for the treatment of hyperphosphataemia during haemodialysis.