Klingel Reinhard, Ahrenholz Peter, Schwarting Andreas, Röckel Arnold
Apheresis Research Institute, Cologne, Germany.
Blood Purif. 2002;20(4):325-33. doi: 10.1159/000063099.
Elimination of uremic solutes with molecular weights up to 60 kD, without significant loss of albumin is an important therapeutic goal to optimize outcomes in chronic hemodialysis patients. To characterize a newly developed polysulfone dialyzer (APS-650) a comparative analysis was performed with a highly advanced polysulfone dialyzer (F-60S) including 22 stable chronic hemodialysis patients. Diffusive clearances were determined, and albumin loss was calculated. The elimination profile of uremic solutes up to 32.0 kD was assessed in vivo by sieving coefficients, clearances, and reduction ratios of beta(2)-microglobulin (11.8 kD), myoglobin (17.2 kD), prolactin (23.0 kD), and alpha(1)-microglobulin (32.0 kD). Hemocompatibility was tested in serial measurements of total white blood cell count, platelet count, C3a, and neutrophil elastase. No significant albumin loss was detected. Significantly higher sieving coefficients, clearances, and reduction ratios for proteins with molecular weight up to 32.0 kD were demonstrated with the newly developed polysulfone membrane. Both polysulfone membranes were equal concerning hemocompatibility parameters. The APS-650 dialyzer allowed optimized hemodialysis treatment with respect to clearance of medium-sized uraemic solutes by high-flux dialysis.
在不显著损失白蛋白的情况下清除分子量高达60 kD的尿毒症溶质是优化慢性血液透析患者治疗效果的一个重要治疗目标。为了对新开发的聚砜透析器（APS - 650）进行特性描述，我们对22例稳定的慢性血液透析患者使用一种高度先进的聚砜透析器（F - 60S）进行了对比分析。测定了扩散清除率，并计算了白蛋白损失量。通过筛分系数、清除率以及β2微球蛋白（11.8 kD）、肌红蛋白（17.2 kD）、催乳素（23.0 kD）和α1微球蛋白（32.0 kD）的降低率，在体内评估了分子量高达32.0 kD的尿毒症溶质的清除情况。通过连续测量总白细胞计数、血小板计数、C3a和中性粒细胞弹性蛋白酶来测试血液相容性。未检测到显著的白蛋白损失。新开发的聚砜膜对分子量高达32.0 kD的蛋白质显示出显著更高的筛分系数、清除率和降低率。两种聚砜膜在血液相容性参数方面相当。APS - 650透析器通过高通量透析，在清除中等大小的尿毒症溶质方面实现了优化的血液透析治疗。
