Document Detail

Choice of dialyzers for HDF.
MedLine Citation:
PMID:  20938135     Owner:  NLM     Status:  In-Process    
Commercial dialyzers were investigated both in vivo and in vitro for a better selection of dialyzers for hemodiafiltration (HDF) therapy. In in vivo online HDF, since a reduction rate of α(1)-microglobulin (α(1)-MG) was determined by the amount of albumin loss regardless of blood flow rate (Q(B)), ultrafiltration rate (Q(F)), and the performance of dialyzer, there is no preference for choice of dialyzers to remove α(1)-MG except for albumin sieving. It was clinically verified that albumin leakage mainly occurred in the first 60 min of treatment even in HD with a polysulfone dialyzer. Ultrafiltration may be more carefully started in order to reduce albumin loss. In an in vitro study, the sieving coefficient for albumin took a peak value at the beginning of the experiment in all polysulfone membrane dialyzers, which corresponded well with the clinical results stated above. Although polymethylmethacrylate membrane dialyzers allowed to penetrate only a limited amount of albumin, they could adsorb a bigger amount of albumin than that penetrated. If dialyzers are used under high Q(B), post-dilution may be preferred because pre-dilution should increase the apparent blood flow rate as well as blood pressure at the inlet. If dialyzers are used under relatively low Q(B), either one of two dilution methods can be applied; however, with pre-dilution it may be easier to control the loss of albumin than with the post-dilution technique. In other words, I would be recommended to employ less albumin-leakage dialyzers when a post-dilution HDF is performed with a large amount of fluid exchange.
Akihiro C Yamashita; Kenji Sakurai
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Publication Detail:
Type:  Journal Article     Date:  2010-10-07
Journal Detail:
Title:  Contributions to nephrology     Volume:  168     ISSN:  1662-2782     ISO Abbreviation:  Contrib Nephrol     Publication Date:  2011  
Date Detail:
Created Date:  2010-10-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7513582     Medline TA:  Contrib Nephrol     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  146-52     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 S. Karger AG, Basel.
Department of Human and Environmental Science, Shonan Institute of Technology, Fujisawa, Japan.
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