Takemoto Yoshiaki, Nakatani Tatsuya, Sugimura Kazunobu, Yoshimura Rikio, Tsuchida Kenji
Department of Urology and Division of Artificial Kidney, Osaka City University Medical School, Osaka, Japan.
Artif Organs. 2003 Dec;27(12):1134-7. doi: 10.1111/j.1525-1594.2003.07156.x.
Endotoxin (ET) in the dialysate is known to adsorb on dialysis membranes made of polyether polymer alloy (PEPA) and polymethylmethacrylate (PMMA). In the present study, we investigated the adsorption of ET on dialysis membranes with a focus on PEPA membranes and polysulfone (PS) membranes that are extensively used in artificial kidneys or as ET-removal filters. In the case of PEPA, the compounding of polyvinylpyrrolidone (PVP) was changed, and both a hydrophobic version and a hydrophilic version were used on the blood side. For the PS dialysis, commercial membranes (APS (Asahi), BSP (Toray), PSN (Fresenius), CLPS (Terumo)) were used. Adsorption was evaluated by exposing both sides of the membrane after it had been primed with physiological saline: the ET concentration on the blood side and dialysate side of the dialysis membrane was monitored during the 240 min from the start of the exposure. When the PEPA membrane was investigated, ET was significantly adsorbed on the hydrophobic version. For PS membranes, ET was adsorbed on the blood side or on both the blood and dialysate sides, depending on the membrane. PS dialysis membranes can adsorb ET but the power and site of adsorption are different even between membranes made of the same material. In addition to electrostatic action attributable to the compounding of hydrophilic agent PVP on the dialysis membrane, the distribution of PVP that was compounded and the potential of the membrane itself are considered to cause differences in adsorption.
已知透析液中的内毒素(ET)会吸附在由聚醚聚合物合金(PEPA)和聚甲基丙烯酸甲酯(PMMA)制成的透析膜上。在本研究中,我们重点研究了ET在透析膜上的吸附情况,尤其是在人工肾中广泛使用的PEPA膜和聚砜(PS)膜或作为ET去除过滤器的情况。对于PEPA,改变了聚乙烯吡咯烷酮(PVP)的复合情况,并且在血液侧使用了疏水型和亲水型两种类型。对于PS透析,使用了市售膜(旭化成的APS、东丽的BSP、费森尤斯的PSN、泰尔茂的CLPS)。通过用生理盐水预充膜后对膜的两侧进行暴露来评估吸附情况:在暴露开始后的240分钟内监测透析膜血液侧和透析液侧的ET浓度。当研究PEPA膜时,ET在疏水型上有显著吸附。对于PS膜,ET根据膜的不同吸附在血液侧或血液侧和透析液侧。PS透析膜可以吸附ET,但即使是由相同材料制成的膜,吸附能力和吸附部位也有所不同。除了透析膜上亲水试剂PVP复合所产生的静电作用外,复合PVP的分布以及膜本身的电位也被认为会导致吸附差异。