In vivo Assessment of a Manual Single Lumen Alternating Micro-Batch Hemodiafiltration System

Area of Science:

• Nephrology
• Biomedical Engineering
• Critical Care Medicine

Background:

• The manual single lumen alternating micro-batch hemodiafiltration (mSLAMB) system is a closed-loop dialysis device for emergency kidney support.
• It addresses critical conditions like fluid overload, hyperkalemia, and acidemia.
• mSLAMB achieves clearance comparable to traditional renal replacement therapy when used in small, high-flow batches.

Purpose of the Study:

• To evaluate the efficacy of the mSLAMB system in a preclinical model.
• To assess its capacity for toxin and fluid removal in acute kidney injury scenarios.

Main Methods:

• A porcine model was utilized to test the mSLAMB hemodiafiltration system.
• Treatment involved monitoring the reduction of uremic toxins and fluorescent tracers.
• Dialysate flow rates and ultrafiltration volumes were optimized.

Main Results:

• Uremic toxins and fluorescent tracers were significantly reduced within 1 hour of mSLAMB treatment.
• Serum potassium levels decreased by over 0.5 mmol/L/h at maximal dialysate flow.
• The system successfully removed up to 250 mL of ultrafiltrate in 8 micro-batch cycles.

Conclusions:

• The mSLAMB system facilitates fluid balance, enabling administration of therapeutic fluids like sodium bicarbonate.
• It offers a potential solution for electrolyte imbalance and volume overload in low-resource settings.
• mSLAMB's low cost, minimal vascular access needs, and independence from electricity make it suitable for wider exploration.