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The Donnan effect in artificial kidney therapy.

S Stiller, H Mann

Life Support Systems : the Journal of the European Society for Artificial Organs

|October 1, 1986

Summary

Calculating sodium gradient in dialysis using the Donnan effect is accurate, even when not at equilibrium. The study found diffusion potentials in hemodialysis and hemofiltration are clinically insignificant.

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Area of Science:

Nephrology
Biomedical Engineering
Physical Chemistry

Background:

Accurate calculation of the effective sodium gradient in dialysis requires accounting for membrane potential difference, typically derived from the Donnan effect.
The Donnan effect is strictly valid only under equilibrium conditions, necessitating an examination of non-equilibrium scenarios in dialysis.

Purpose of the Study:

To investigate the impact of deviation from equilibrium on sodium transport during hemodialysis and hemofiltration.
To determine the clinical significance of diffusion potentials arising from non-equilibrium conditions in dialysis.

Main Methods:

Mathematical analysis involving the integration of local transport rates over the membrane area.
Utilizing the Nernst-Planck equation with the constant field assumption to calculate local transport rates.
Presenting experimental evidence to support theoretical findings.

Main Results:

Deviation from equilibrium in hemodialysis and hemofiltration generates a diffusion potential across the membrane.
This diffusion potential was found to be too small to possess any significant clinical relevance.
The observed better tolerance of hemofiltration compared to hemodialysis cannot be attributed to differences in sodium transport.

Conclusions:

The calculation of sodium transport in dialysis therapy using the equilibrium Donnan effect provides sufficient accuracy for routine kinetic considerations.
The study clarifies that non-equilibrium conditions do not introduce clinically significant diffusion potentials in dialysis.
Differences in patient tolerance between hemodialysis and hemofiltration are not explained by variations in sodium transport.

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