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- Title
Effects of a reduced inner diameter of hollow fibers in hemodialyzers.
- Authors
Ronco, Claudio; Brendolan, Alessandra; Lupi, Andrea; Metry, George; Levin, Nathan W.
- Abstract
Effects of a reduced inner diameter of hollow fibers in hemodialyzers. Background. The clearance of middle molecules in high-flux hemodialyzers is due to the higher contribution of convection in the overall solute transport. Although net filtration can be maintained low by the machine control, internal filtration in the proximal part of the dialyzer remains high. The final fluid balance is achieved by significant amounts of backfiltration in the distal part of the dialyzer. To increase further middle molecule clearance (MMK), hemodiafiltration has been used. This technique, however, requires complex machines and large amounts of substitution fluid. We present a novel solution to increase the convective transport of middle molecules in high flux dialyzers without the need for substitution fluids. In particular, high-flux dialyzers with a reduced hollow fiber diameter are compared with standard dialyzers in terms of internal filtration and solute clearances. Methods. Hemodialyzers with 175 μ inner diameter polysulfone fibers were compared with standard 200 μ polysulfone hollow fiber dialyzers. The study was carried out in vitro using a previously published method to measure internal filtration and backfiltration rates. The method is based on the detection by a γ camera of segmental variations in concentration along the length of the dialyzer of a nondiffusable Tc99-labeled marker molecule injected in the blood in vitro circuit. At the same time, pressures were detected in the blood and dialysate compartment. The system was operated at zero net filtration maintaining volumetrically constant both dialysate and blood circuits. In vivo clearances were also measured for solutes with different molecular weight. Results. The pressure drop in the blood compartment at 300 mL/min of blood flow passed from 112 to 159 mm Hg. At the same blood flow, the internal filtration-backfiltration rates increased from 23.1 to 48.2 mL/min. This resulted in a significant...
- Subjects
HEMODIALYZERS; SOLUTION (Chemistry)
- Publication
Kidney International, 2000, Vol 58, Issue 2, p809
- ISSN
0085-2538
- Publication type
Article
- DOI
10.1046/j.1523-1755.2000.00230.x