Urea elimination using a cold activated-carbon artificial tubulus for hemofiltration

Urea adsorption on active carbon is reversible and temperature-dependent. Urea adsorption isotherms of different carbons were determined at 0 degrees C and 65 degrees C within the equilibrium concentration range of 1.0-3.4 gm/L. At low urea concentrations considerable differences (3.4-13.0 gm/kg carbon at concentrations of 1.0 gm/L) were found between different types of activated carbon. The overall internal surface area was of minor importance compared to the pore size distribution. Adsorbing at low temperature, desorbing at high temperature, and flushing the carbon adsorber with a limited volume of the liquid to be purified yielded an "artificial urine." Compared to the original urea concentration of the filtrate, this "artificial urine" had an increased urea concentration. From a 36-liter volume containing 90 grams urea dissolved in saline, 18 liters were recirculated at a flow rate of 100 ml/min. The influence of adsorption and desorption time intervals was evaluated. After one to one and a half hours the carbon was saturated with urea. After saturation, about 1.4 grams urea were eliminated per cycle. In the "artificial urine" urea concentrations of up to 4.5 gm/L were found when the original solution contained only 2.5 gm/L. In the "patient" volume the urea concentration decreased from 2.5 gm/L to 1.9-2.1 gm/L. Within three hours a total of 22 grams of urea was removed by 3 x 120 grams activated carbon corresponding to removal of 50% of the urea passing the "artificial tubulus." The advantage of this system is that after priming, no additional physiological solution would be necessary. The necessity of excessive safety controls, additional electrolyte adjustment, energy demand in the form of direct current, and great amounts of waste in solid form lead to the conclusion that for intermittent hemofiltration treatment, commercially produced and controlled infusion solution is preferable.