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Dialyzer fiber bundle volume during hemodialysis using large-surface dialyzers
Martine Leblanc1, Jean-Philippe Lafrance, Alexandra Renald
1Hemodialysis Unit, Maisonneuve-Rosemont Hospital, Montreal, QC, Canada.
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|November 23, 2006
Summary
Fiber bundle volume (FBV) in large-surface dialyzers remains stable during 4-hour hemodialysis, regardless of heparin use or saline flushes. This indicates dialyzer surface loss does not explain reduced dialysis doses.
Area of Science:
- Nephrology
- Biomedical Engineering
Background:
- Dialyzer performance can decline during hemodialysis, potentially due to fiber bundle volume (FBV) changes.
- Understanding FBV stability is crucial for optimizing dialysis dose delivery.
Purpose of the Study:
- To measure and compare the FBV of three large-surface dialyzers during chronic hemodialysis.
- To assess the impact of varying heparin doses and saline flushes on FBV.
Main Methods:
- Ultrasound dilution was used to measure FBV hourly in 54 hemodialysis sessions across three dialyzer types (Nephral ST500, Tricea210, Optiflux200NR).
- Patients were studied with no heparin, tight heparinization, or large heparin doses.
- An additional study evaluated the effect of saline flushes in heparin-free hemodialysis.
Main Results:
- FBV remained stable for up to 4 hours across all dialyzer types and heparinization strategies.
- No significant differences in dialyzer appearance or clot formation were observed.
- Saline flushes did not alter FBV in heparin-free hemodialysis.
Conclusions:
- Large-surface dialyzer FBV is well-maintained during 4-hour high-flux hemodialysis.
- FBV loss does not account for discrepancies between prescribed and delivered dialysis doses.
- The AN69ST membrane is not excessively thrombogenic and does not necessitate saline flushes in heparin-free dialysis.
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