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Measurement of back clearance.
1Research Division, Yokohama Dai-ichi Hospital, Japan.
ASAIO Transactions
|July 1, 1990
Summary
New dialysis membranes can cause solute backflow into the blood. This study quantifies solute transfer rates, finding significant back clearance of toxins like inulin and lysozyme, even with ultrafiltration, necessitating contamination control strategies.
Area of Science:
- Nephrology
- Biomedical Engineering
- Materials Science
Background:
- Advancements in dialysis membranes have shifted focus to back filtration phenomena.
- New membranes efficiently remove low molecular weight proteins, exacerbating back filtration and back diffusion concerns.
Purpose of the Study:
- To quantify the mass transfer rate of solutes from the dialysate to the blood compartment.
- To assess the impact of ultrafiltration on solute back clearance.
Main Methods:
- Utilized inulin, lysozyme, and alpha-lactoalbumin as markers for toxic/antigenic substances.
- Tested dialyzers CLSU-12W, AM-FP10, BK-1.0P, and FB-110U under controlled conditions.
- Set blood flow at 200 ml/min, dialysate flow at 500 ml/min, and ultrafiltration (QF) from 0 to 50 ml/min.
Main Results:
- Inulin back clearance ranged from 16 to 26 ml/min, and lysozyme back clearance ranged from 10 to 34 ml/min.
- Significant solute transfer into the blood compartment was observed.
- Back clearance did not substantially decrease with increasing ultrafiltration (QF).
Conclusions:
- Substantial solute backflow into the blood compartment occurs with new dialysis membranes.
- Effective contamination control measures, such as dialysis line clean-up or online protein adsorbers, are crucial to prevent blood side contamination.