title: Non-machinery dialysis that achieves blood purification therapy without using full-scale dialysis machines.
abstract: An electrical or water supply and a blood purification machine are required for renal replacement therapy. There is a possibility that acute kidney injury can occur in large numbers and on a wide scale in the case of a massive earthquake, and there is the potential risk that the current supply will be unable to cope with acute kidney injury cases. However, non-machinery dialysis requires exclusive circuits and has the characteristic of not requiring the full-scale dialysis machines. We performed perfusion experiments that used non-machinery dialysis and recent blood purification machines in 30-min intervals, and the effectiveness of non-machinery dialysis was evaluated by the assessing the removal efficiency of potassium, which causes lethal arrhythmia during acute kidney injury. The non-machinery dialysis potassium removal rate was at the same level as continuous blood purification machines with a dialysate flow rate of 5 L/h after 15 min and continuous blood purification machines with a dialysate flow rate of 3 L/h after 30 min. Non-machinery dialysis required an exclusive dialysate circuit, the frequent need to replace bags, and new dialysate exchanged once every 30 min. However, it can be seen as an effective renal replacement therapy for crush-related acute kidney injury patients, even in locations or facilities not having the full-scale dialysis machines.
authors.affiliation: Department of Urology, School of Medicine, Iwate Medical University, 19-1, Uchimaru, Morioka, 020-8505, Japan. takayabe@iwate-med.ac.jp.
authors.forename: Takaya
authors.identifier: http://orcid.org/0000-0001-9867-8300
authors.initials: T
authors.lastname: Abe
authors.affiliation: Department of Urology, School of Medicine, Iwate Medical University, 19-1, Uchimaru, Morioka, 020-8505, Japan.
authors.forename: Mistutaka
authors.initials: M
authors.lastname: Onoda
authors.affiliation: Department of Urology, School of Medicine, Iwate Medical University, 19-1, Uchimaru, Morioka, 020-8505, Japan.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Matsuura
authors.affiliation: Department of Urology, School of Medicine, Iwate Medical University, 19-1, Uchimaru, Morioka, 020-8505, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Sugimura
authors.affiliation: Department of Urology, School of Medicine, Iwate Medical University, 19-1, Uchimaru, Morioka, 020-8505, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Obara
authors.affiliation: Clinical Engineering Center, Iwate Medical University Hospital, 19-1, Uchimaru, Morioka, 020-8505, Japan.
authors.forename: Toshiya
authors.initials: T
authors.lastname: Sato
authors.affiliation: Clinical Engineering Center, Iwate Medical University Hospital, 19-1, Uchimaru, Morioka, 020-8505, Japan.
authors.forename: Mihoko
authors.initials: M
authors.lastname: Takahashi
authors.affiliation: Clinical Engineering Center, Iwate Medical University Hospital, 19-1, Uchimaru, Morioka, 020-8505, Japan.
authors.forename: Kenta
authors.initials: K
authors.lastname: Chiba
authors.affiliation: Kidney Center, Jiseikai Kinen Hospital, 3-11-3, Nishidai, Itabashi Ward, Tokyo, 175-0045, Japan.
authors.forename: Tomiya
authors.initials: T
authors.lastname: Abe
mesh_terms: D058186:Acute Kidney Injury / Q000628:therapy*; D015314:Dialysis Solutions / Q000494:pharmacology*; D004867:Equipment Design; D006801:Humans; D006435:Renal Dialysis / Q000295:instrumentation*
chemical_list: D015314:Dialysis Solutions
keywords: Crush-related acute kidney injury; Potassium; Renal replacement therapy