Performance of polysulfone membrane dialyzers and dialysate flow pattern |
| |
Authors: | Ayumu Nakashima Satoshi Ogata Shigehiro Doi Michihiro Yamahira Satoe Naraki Norihisa Takasugi Toshifumi Ohmoto Takafumi Ito Takao Masaki Noriaki Yorioka |
| |
Affiliation: | (1) Department of Molecular and Internal Medicine, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan;(2) Department of Internal Medicine, Sanyo Hospital, 2-8-2 Nogami-cho, Fukuyama 720-0815, Japan;(3) Department of Dialysis, Hakuai Hospital, Kure, Japan;(4) Department of Radiology, Kure City Medical Association Hospital, Kure, Japan;(5) Section of Nephrology, Department of Internal Medicine, Shimane University Faculty of Medicine, Izumo, Japan;(6) Department of Advanced Nephrology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan |
| |
Abstract: | Background It is important to observe the flow pattern of dialysate when evaluating dialyzer function and developing the most appropriate design. We investigated dialysate flow through two polysulfone membrane dialyzers (TS-UL [Toray Medical] and APS-S [Asahi Medical]) by computed tomography (CT), with barium sulfate as the contrast medium. We also performed a clinical comparison of these two dialyzers. Methods For the in vitro experiment, after confirming the steady-state flow of mock blood (xanthan gum solution; 200 ml/min) and dialysate (500 ml/min), fresh dialysate, containing 5% (w/v) barium sulfate was perfused, and longitudinal CT scans of the dialyzer were obtained. Then the concentration of barium sulfate was measured (in Hounsfield units) in three fixed regions of interest. For the in vivo experiment, 12 patients on stable hemodialysis who had been using the APS-S for more than 1 month were switched to the TS-UL for 1 month and changes in various parameters were assessed. Results The distribution of dialysate was homogeneous on CT scans of the TS-UL, but not on scans of the APS-S. The dialysate concentration curves for the three regions of interest were similar with the TS-UL, but not with the APS-S. Clearance of urea nitrogen and albumin loss were both significantly higher with the TS-UL than with the APS-S. The decrease in alpha 1-microglobulin was larger with the TS-UL than with the APS-S, but not significantly. Conclusions Clearance of substances over a wide range of molecular weights was higher with the TS-UL than with the APS-S, and differences in the design of the dialysate compartment may have been involved in this feature. |
| |
Keywords: | Dialyzer Hemodialysis Dialysate Computed tomography Contrast medium Clearance |
本文献已被 PubMed SpringerLink 等数据库收录! |
|