Barile R G, Wang N H, Blake D E, Belcastro P F, Gupta S, Regnier F E, Thornhill J A, Kessler D P, Ash S R
Artif Organs. 1982 Aug;6(3):267-79. doi: 10.1111/j.1525-1594.1982.tb01672.x.
Previous theoretical analysis has indicated that adequate mass transfer is possible in a dialyzer with reciprocating membrane motion provided that the dialysate concentration of uremic substances is kept low. Earlier models have utilized a collection of sorbents (charcoal, urease, and a cation exchanger) constrained next to the dialyzer membranes. We have designed a new dialyzer with a sorbent suspension having free access from a reservoir to the spaces between membrane packages. At a treatment rate of 150 ml/min/m2, the in vitro creatinine clearance is 75 ml/min/m2, which agrees within experimental accuracy with the theoretical prediction. The creatinine clearance, flow resistance, and compliance of the dialyzer are constant during four to six hours of testing. In vivo tests have been performed during urea and creatinine infusion in a normal dog and in a dog with 3/4 nephrectomy. The in vivo creatinine clearance agrees within 10% with the in vitro clearance. Sodium, potassium, calcium, and bicarbonate fluxes are acceptable for patients in renal failure. The new design allows a higher capacity for urea and creatinine, since larger amounts of sorbent may be used.
先前的理论分析表明,在透析器中,只要尿毒症物质的透析液浓度保持较低,通过往复式膜运动就有可能实现充分的质量传递。早期的模型使用了一组吸附剂(木炭、脲酶和阳离子交换剂),将其限制在透析器膜旁边。我们设计了一种新的透析器,其中吸附剂悬浮液可以从储存器自由进入膜组件之间的空间。在150 ml/min/m²的治疗速率下,体外肌酐清除率为75 ml/min/m²,在实验精度范围内与理论预测相符。在四到六个小时的测试过程中,透析器的肌酐清除率、流动阻力和顺应性保持恒定。在正常狗和四分之三肾切除的狗中进行了尿素和肌酐输注期间的体内测试。体内肌酐清除率与体外清除率的差异在10%以内。对于肾衰竭患者,钠、钾、钙和碳酸氢盐通量是可以接受的。这种新设计允许更高的尿素和肌酐清除能力,因为可以使用更多的吸附剂。