**3. Results**

The data search identified 252 citations, although some of these were dual citations identified in both search engines. Of the 252 citations, 11 studies were identified where a hypothesis was tested involving the use of liposomes in vitro or in vivo to augment dialysis of either endogenous toxins or intoxicants. An additional two studies were identified (Figure 1).

**Figure 1.** PRISMA diagram of studies included in this review.

As no studies involving lipid-based particles other than liposomes were found, we refer to liposomes only in the review. The use of liposomes to increase the extraction of endogenous toxins and intoxicants has been investigated in 13 studies. The use of pHgradient liposomes with an acidic core to increase the extraction of ammonia is the most investigated area. Improving dialysis of the protein-bound endogenous toxins relating to renal failure with soy phospholipid (SP)-based liposomes, cationic liposomes and liposomes made with linoleic acid was the subject of four studies. Three studies related to intoxicants, investigating the capacity of liposomes to augment dialysis for verapamil, amitriptyline, haloperidol, propranolol and phenobarbitone. One study evaluated liposome-supported enzymatic peritoneal dialysis, and one study evaluated the effects of SP liposomes on dialysis of protein-bound endogenous toxins, which accumulate in hepatic failure.

A summary of studies with experimental models, liposome type and targets, including exogenous and endogenous toxic substances, and results relevant to the model is shown in Table 1.

1


### **Table 1.** Summary of studies included in the review.


**Table 1.** *Cont.*


### **Table 1.** *Cont.*


**Table 1.** *Cont.*

Table abbreviations: CARPA—complement activation-related pseudoallergy; DOPG—1,2-dioleoyl-*sn*-glycero-3-phosphoglycerol; DPPC dipalmitoylphosphatidylcholine; HA—hippuric acid; ILE—intravenous lipid emulsion; IS—indoxyl sulphate; IV intravenous; LA—linoleic acid; LSPD—liposome-supported peritoneal dialysis; PBUT—protein-bound uraemic toxin; PCS—p-cresyl sulphate; SP—soy phospholipid. † indicates a positive in vitro finding which translated into a positive in vivo finding.
