Alternate repetition of short fore- and backfiltrations reduces convective albumin loss.

Abstract:

:An effective therapeutic means to remove relatively large polypeptide uremic toxins seems to be a hemofiltration (HF) or hemodiafiltration (HDF) employing a larger-pore membrane, that is, a protein-permeable membrane. With either method, however, a significant amount of albumin will be lost into the ultrafiltrate or dialysate. Now, repetition of alternate short fore- and backfiltrations may prevent the development of the ultrafiltration-induced higher albumin concentration on the membrane surface (protein concentration polarization), where a single forefiltration time is shorter than the time needed for completion of protein concentration polarization. Since the albumin concentration on the protein-permeable membrane surface will be one of the determinants of albumin loss by convection, such HDF treatment may reduce protein loss into the dialysate. To examine this assumption, we alternately repeated short and rapid fore- and backfiltrations (push/pull HDF) through a protein-permeable membrane, each less than 1 second in duration and at each filtration volume of 15 ml, where a pyrogen-free dialysate was supplied. The present results indicated that the albumin amount lost by push/pull HDF was approximately one-third of that by conventional HDF. Nevertheless, the reduction rates of beta 2-microglobulin and myoglobin were significantly greater by push/pull HDF than by conventional HDF.

journal_name

Kidney Int

journal_title

Kidney international

authors

Shinzato T,Miwa M,Nakai S,Takai I,Matsumoto Y,Morita H,Miyata T,Maeda K

doi

10.1038/ki.1996.333

subject

Has Abstract

pub_date

1996-08-01 00:00:00

pages

432-5

issue

2

eissn

0085-2538

issn

1523-1755

pii

S0085-2538(15)59627-0

journal_volume

50

pub_type

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