Characterization of molecular transport in artificial kidneys

Transport characterizations of artificial kidneys require the use of multiple marker molecules of various sizes, including small solutes, middle molecules, and albumin. Previous approaches for evaluating hemodialyzer transport performance are reviewed. New data obtained from in vitro experiments comparing 5 low molecular weight proteins of approximately the same molecular size as markers for middle molecule transport also are described. Sieving coefficients for marker low molecular weight proteins may vary substantially for a given artificial kidney membrane. Furthermore, sieving coefficients for marker proteins that do not absorb significantly to the membrane are comparable to those for polydisperse dextrans. These observations suggest that other protein properties besides molecular size are important determinants of protein sieving coefficients across artificial kidney membranes. We conclude that low molecular weight proteins can behave differently from one another and generalizations about artificial kidney membrane transport from data obtained on a single protein may be problematic, and that both low molecular weight proteins and polydisperse dextrans are useful markers of middle molecular transport across artificial kidney membranes.