Shaffer Justin F, Zydney Andrew L
Department of Chemical Engineering, The Pennsylvania State University, University Park, PA 16802, USA.
ASAIO J. 2005 Nov-Dec;51(6):748-53. doi: 10.1097/01.mat.0000185569.27103.88.
Hyperphosphatemia is a major problem for hemodialysis patients due to inadequate phosphate clearance during dialysis. The objective of this study was to understand the effects of bleach reprocessing on phosphate clearance. Data were obtained using Fresenius polysulfone dialyzers exposed to bleach in an in vitro dialysis. The phosphate clearance decreased slightly after a single reprocessing cycle, with more than a 10% reduction observed after 15 cycles. Streaming potential measurements showed that bleach reprocessing caused an increase in the negative charge on the polysulfone membrane, suggesting that the change in phosphate clearance was due to an increase in electrostatic repulsion. The changes in clearance and surface charge were consistent with theoretical calculations of the effects of electrostatic interactions on solute diffusion. These results provide the first evidence that bleach reprocessing can reduce phosphate clearance due to electrostatic interactions between the phosphate anion and negatively charged dialysis membranes.
高磷血症是血液透析患者面临的一个主要问题，因为透析过程中磷酸盐清除不充分。本研究的目的是了解漂白剂再处理对磷酸盐清除的影响。数据是在体外透析中使用暴露于漂白剂的费森尤斯聚砜透析器获得的。单次再处理循环后磷酸盐清除率略有下降，15次循环后观察到下降超过10%。流动电位测量表明，漂白剂再处理导致聚砜膜上的负电荷增加，这表明磷酸盐清除率的变化是由于静电排斥增加所致。清除率和表面电荷的变化与静电相互作用对溶质扩散影响的理论计算结果一致。这些结果首次证明，由于磷酸根阴离子与带负电荷的透析膜之间的静电相互作用，漂白剂再处理会降低磷酸盐清除率。
