四种不同膜材料透析器溶质清除能力的临床研究

目的 比较维持性血液透析(MHD)患者应用的4种不同膜透析器对溶质清除的能力.方法 60例MHD患者.基线水平,所有患者均应用合成膜低通量聚砜(PS)膜透析器透析至少3个月.患者被随机分成3组,每组应用不同膜材质透析器透析,分别为高通量聚醚砜膜透析器(PES)组、高通量三醋酸纤维素膜透析器(CTA)组、低通量聚甲基丙烯...

The solutes removal capability in four different membrane dialyzers in hemodialysis maintenance patients

Objective Following the introduction of modified cellulos and then synthetic membrane dialyzers,it was realized that the capability of solutes removal depended on the dialyzer membrane’s composition and permeability. We designed a six month prospective,randomized,controlled study to determine several parameters of solutes removal in MHD patients treated with four different membrane dialyzers. Methods Sixty MHD patients were enrolled in the study. Synthetic dialyzer,polysulfone (PS) membrane was used in all patients for at least 3 months at baseline. Then the patients were randomly divided into three groups based on different dialyzer membranes:ployethersulfone (PES) high-flux membrane,cellulose triacetate (CTA) high-flux membrane,and polymethylmethacrylate (PMMA) low-flux membrane. All these dialyser were used for 6 months. There was no dialyzer reuse in this study. The solutes removal markers were detected repeatedly at different time points. Results There were no statistically significant differences of BUN,Cr,UA and ADMA among different dialyzer groups. The reduction ratio of β2-microglobulin decreased significantly when changed from PS membrane dialyzers to PES membrane dialyzers There were no significant differences either among three groups at baseline or transfer dialyzers from PS membrane to CTA or PMMA membrane. Conclusion There are no significant differences in the clearances of small molecule uremic toxins (creatinin,urea,uric acid) and protein-bond small molecule toxin ADMA among four dialyzer membranes. The high flux membranes (PES and CTA membranes) are not superior to low flux synthetic membrane (PMMA membrane)on the removal of β2-microglobulin. The results of this study suggest that the capability of adsorption of PMMA membrane may be more important for β2-microglobulin clearance.