Effects of ultrafiltration on solute clearances in hollow fiber artificial kidneys

Although solute clearances in artificial kidney coils increase with ultrafiltration (UF), we have previously shown that increases are usually less than UF rate (most likely because of decreases in diffusive transport with UF coils and, for larger solutes, molecular sieving). The present studies demonstrate the effects of UF on clearances of Na and bromsulphalein (BSP) (mol. wt. 838) in hollow fiber dialyzers. Clearances were measured at increasing transmembrane hydrostatic pressures at perfusion rates of 200 and 500 ml. per minute. Fractions of total clearance attributable to diffusion as compared to solvent drag forces were calculated. Sieving coefficients were determined in studies where diffusion was minimized and clearance was primarily by solvent drag. Clearance increases were less than UF rate only for BSP; molecular sieving most likely accounts for the difference at high perfusion rates. Only at 200 ml. per minute was slight decrease of diffusion with UF suggested. Thus, in contrast to coils, there is minimal or no decrease in diffusion with UF in hollow fiber dialyzers.