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Related Experiment Videos

Hemodiafiltration without replacement fluid. An experimental study.

P M Ghezzi1, R Gervasio, V Tessore

  • 1Nephrology Department, S. Croce Hospital, Cuneo, Italy.

ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|January 1, 1992
PubMed
Summary
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Paired filtration dialysis (PFD) ultrafiltrate can be regenerated into safe replacement fluid using charcoal cartridges. This innovation in hemodiafiltration (HDF) offers a sterile, pyrogen-free solution with essential electrolytes and bicarbonate.

Area of Science:

  • Nephrology
  • Biomedical Engineering
  • Fluid Dynamics

Background:

  • Paired filtration dialysis (PFD) is a unique hemodiafiltration (HDF) method where ultrafiltrate is kept separate.
  • Convective dialysis techniques require sterile replacement fluid with specific electrolyte and buffer compositions.
  • The viability of using PFD's ultrafiltrate as replacement fluid was previously unconfirmed.

Purpose of the Study:

  • To investigate the regeneration of PFD ultrafiltrate into a usable replacement fluid.
  • To determine the composition of regenerated PFD ultrafiltrate after treatment with a charcoal cartridge.
  • To assess the safety and efficacy of using regenerated ultrafiltrate as replacement fluid in HDF.

Main Methods:

  • Ultrafiltrate from PFD sessions was passed through an uncoated adsorbent charcoal cartridge (130 g).

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  • The regenerated fluid's composition, including electrolytes, bicarbonate, and various solutes, was analyzed.
  • The technique was experimentally studied over 24 standard PFD sessions.

    • Main Results:

    • Charcoal cartridge treatment effectively removed small and medium-to-large solutes while preserving electrolytes (Na+, K+, Ca++) and bicarbonate.
    • The regenerated ultrafiltrate exhibited a mean composition suitable for replacement fluid: pH 7.467, HCO3- 27.0 mmol/L, Na+ 137.4 mmol/L.
    • Mean ultrafiltrate volume was 9,950 ± 860 ml, yielding a significant volume of potential replacement fluid.

    Conclusions:

    • Regenerated PFD ultrafiltrate is a viable sterile and pyrogen-free replacement fluid.
    • This method conserves resources by utilizing generated ultrafiltrate.
    • PFD ultrafiltrate regeneration presents a promising advancement in HDF fluid management.