A study of the basic principles determining the performance of several high-flux dialyzers.
The clearance characteristics of several commercially available high-flux dialyzers made from cellulose acetate, polyacrylonitrile, polysulphone, and polymethylmethacrylate were studied in vivo. The impact of increasing surface area and adding ultrafiltration on the clearances of small- and larger-molecular-weight species was assessed. The results show there are major differences in large-molecular-weight substance substance handling by different dialyzers as shown by differences in beta 2-microglobulin clearance, independent of ultrafiltration capacity. Membranes made from similar material, eg, Asahi's PAN and Hospal's AN-69 membrane, both made from polyacrylonitrile, differ significantly in their beta 2-microglobulin clearance. Increased surface area results in much greater increase in large-molecular-weight substance clearance. The present study clearly demonstrates that high water flux is not related to high large-molecular-weight permeability. Decisions with respect to impact on dialysis must be based on a knowledge of both the large- and small-molecular-weight permeabilities of the various membranes.
Jindal
K K
KK
Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
McDougall
J
J
Woods
B
B
Nowakowski
L
L
Goldstein
M B
MB
D000180:Acrylic Resins; D001672:Biocompatible Materials; D002482:Cellulose / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D007688:Kidneys, Artificial; D008297:Male; D008567:Membranes, Artificial; D008768:Methylmethacrylates; D011108:Polymers; D006435:Renal Dialysis / Q000295:instrumentation*; D013450:Sulfones; D001613:beta 2-Microglobulin
D000180:Acrylic Resins; D001672:Biocompatible Materials; D008567:Membranes, Artificial; D008768:Methylmethacrylates; D011108:Polymers; D013450:Sulfones; D001613:beta 2-Microglobulin; C010504:polyacrylonitrile; C017662:polysulfone P 1700; C005062:acetylcellulose; D002482:Cellulose