Sato Yuichi, Kimura Kenjiro, Chikaraishi Tatsuya
Department of Urology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, 216-8511, Japan.
J Artif Organs. 2010 Jul;13(2):113-6. doi: 10.1007/s10047-010-0506-z. Epub 2010 Jun 5.
Over the last decade, hemodialysis with enhanced internal filtration (IF) has been investigated as an alternative to conventional dialysis. Several factors affect IF, including the geometry and permeability of hollow-fiber dialyzers. Although various studies have been performed, the association between IF and membrane permeability has not been fully examined because of the difficulty in measuring IF. Therefore, in this study, we set up an experimental circuit and attempted to directly measure IF as well as membrane permeability in five dialyzers. In the circuit, we placed two dialyzers of the same type in series, and a special sampling port between them, thereby making it possible to determine IF by measuring the extent to which blood was concentrated between the two dialyzers. We showed that a significant amount of IF occurred in this tandem-dialyzer circuit, ranging from 23.5 to 100 ml/min, which increased linearly with increasing membrane permeability. We also showed that membrane permeability was reduced in the first dialyzer to a greater extent than in the second one after four hours of circulation, suggesting that filtration caused substantial membrane fouling. In this study we practically demonstrated that membrane permeability is highly relevant to the phenomenon of IF.
在过去十年中，具有增强型内部过滤（IF）功能的血液透析已被作为传统透析的替代方法进行研究。有几个因素会影响内部过滤，包括中空纤维透析器的几何形状和通透性。尽管已经进行了各种研究，但由于测量内部过滤存在困难，内部过滤与膜通透性之间的关联尚未得到充分研究。因此，在本研究中，我们建立了一个实验回路，并尝试直接测量五种透析器的内部过滤以及膜通透性。在该回路中，我们将两个相同类型的透析器串联放置，并在它们之间设置一个特殊的采样端口，从而通过测量两个透析器之间血液浓缩的程度来确定内部过滤。我们发现，在这个串联透析器回路中发生了大量的内部过滤，范围从23.5到100毫升/分钟，并且随着膜通透性的增加呈线性增加。我们还发现，循环四个小时后，第一个透析器的膜通透性比第二个透析器降低的程度更大，这表明过滤导致了大量的膜污染。在本研究中，我们切实证明了膜通透性与内部过滤现象高度相关。
