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一种新型亲水性透析膜的安全性和有效性研究。

A Study on the Safety and Efficacy of an Innovative Hydrophilic Dialysis Membrane.

作者信息

Maduell Francisco, Escudero-Saiz Victor Joaquín, Cuadrado-Payán Elena, Rodriguez-Garcia Maria, Gómez Miquel, Rodas Lida María, Fontseré Néstor, Salgado Maria Del Carmen, Casals Gregori, Rico Nayra, Broseta José Jesús

机构信息

Nephrology and Renal Transplantation, Hospital Clínic de Barcelona, 08036 Barcelona, Spain.

Biochemistry and Molecular Genetics Department-CDB, Hospital Clínic de Barcelona, 08036 Barcelona, Spain.

出版信息

Membranes (Basel). 2025 Jan 14;15(1):30. doi: 10.3390/membranes15010030.

Abstract

The dialysis membrane based on a hydrophilic polymer (Hydrolink NV) was designed to enhance the movement of adsorbed water at the blood-membrane interface, aiming to achieve antithrombogenic and antifouling effects. This study aimed to assess the performance and albumin loss of the Hydrolink NV dialyzer in hemodialysis (HD) and post-dilution hemodiafiltration (HDF) with different infusion flows (Qis) and compare it with the hydrophilic FX CorAL dialyzer in post-dilution HDF. A prospective study was carried out in 20 patients. Patients underwent five dialysis sessions with the same routine dialysis parameters: four sessions with the Toraylight NV 2.1 (HD, post-dilution HDF with 50, 75 or auto-substitution Qi) and one with the FX CorAL 800 (post-dilution HDF with auto-substitution Qi). The reduction ratios' (RRs') wide range of molecular weight molecules were assessed and the dialysate albumin loss was quantified. The lowest β-microglobulin, indoxyl-sulfate, and p-cresyl sulfate RR values were observed with the Toraylight NV 2.1 in HD, and they improved progressively with an increased Qi, without differences being observed between the two dialyzers in auto-substitution. A different removal profile was observed in terms of myoglobin, kFLC, prolactin, α-microglobulin, α-acid glycoprotein, and λFLC, whose RRs also improved progressively with an increased Qi but were significantly higher with the Toraylight NV than the CorAL in the same convective condition. There were significant differences in the albumin dialysate losses, with the highest value obtained with the Toraylight NV in auto-substitution HDF, with more than 50% of patients surpassing 5 g per session. The Toraylight NV dialyzer has great potential for efficacy but should be used at the optimal convective volume (Qi not exceeding 75 mL/min or FF not exceeding 25%) to avoid excessive albumin loss.

摘要

基于亲水性聚合物(Hydrolink NV)的透析膜旨在增强血液 - 膜界面处吸附水的移动,以实现抗血栓形成和抗污染效果。本研究旨在评估Hydrolink NV透析器在不同输注流量(Qis)的血液透析(HD)和后置稀释血液透析滤过(HDF)中的性能及白蛋白损失情况,并将其与后置稀释HDF中的亲水性FX CorAL透析器进行比较。对20例患者进行了一项前瞻性研究。患者采用相同的常规透析参数进行了五次透析治疗:四次使用东丽之光NV 2.1(HD、后置稀释HDF,Qis分别为50、75或自动置换),一次使用FX CorAL 800(后置稀释HDF,自动置换Qis)。评估了不同分子量分子的清除率(RRs)范围,并对透析液白蛋白损失进行了定量。在HD中,东丽之光NV 2.1观察到最低的β-微球蛋白、硫酸吲哚酚和对甲酚硫酸盐RR值,且随着Qis增加而逐渐改善,在自动置换时两种透析器之间未观察到差异。在肌红蛋白、游离轻链(kFLC)、催乳素、α-微球蛋白、α-酸性糖蛋白和λFLC方面观察到不同的清除模式,其RRs也随着Qis增加而逐渐改善,但在相同对流条件下,东丽之光NV的RRs显著高于CorAL。透析液白蛋白损失存在显著差异,在自动置换HDF中,东丽之光NV获得的最高值超过50%的患者每次透析超过5 g。东丽之光NV透析器具有很大的疗效潜力,但应在最佳对流体积(Qis不超过75 mL/min或滤过分数不超过25%)下使用,以避免白蛋白过度损失。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/affe/11767910/23c2666031e5/membranes-15-00030-g001.jpg

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