Is 3000 S Hospal a suitable dialyzer to shorten dialysis time schedule? A cooperative study on biofiltration
Fuiano, G.; Memoli, B.; Dal Canton, A.; Papa, A.; Pacchiano, G.; Rampino, T.; Marcuccio, F.; Andreucci, V.E.; Cioffi, L.; Martucciello, L.
International Journal of Artificial Organs 9(Suppl): 31-34
1986
ISSN/ISBN: 0391-3988 PMID: 3557669 Document Number: 285182
The Biofilter 3000 S Hospal may combine higher convective clearance rates (Cc) with usual diffusive clearance rates (Cd) (i.e. similar to Cuprophan dialyzers), giving a higher total clearance rate (Ct) of small and middle molecules. Use of the Biofilter has been suggested to shorten dialysis time schedules. This study was carried out in 8 patients on RDT 3 times weekly, by cuprophan filter and acetate dialysis. The patients were shifted to dialysis with 3000 S guided by two principles: a) to shorten dialysis time by 1 hour per session, and b) to reinfuse 6 liters of bicarbonate-saline solution (40 mEq/l) per single dialysis. Besides the usual clinical and laboratory controls, in three patients clearance studies were carried out during four different dialysis sessions: Ct, Cc and Cd of urea K+, creatinine, uric acid and phosphate were measured. No change was observed in the main clinical and laboratory parameters after 3-5 months (average 3.9) of treatment with Biofilter 3000 S; in addition, serum alkaline phosphatase concentration decreased progressively. Clearance results, however, indicate that the expected high values of Ct do not occur, because Cd decreases as Cc is increased. A primary goal of research in hemodialysis is to reduce the average time of treatment while ensuring simultaneously "physiological" dialysis. A possible approach to this problem is to use dialyzers with highly permeable and biocompatible membranes such as the "biofilter" 3000 S Hospal. The biofilter 3000 S Hospal, in fact, combines the high convective clearance rate (Cc) of the AN 69 S membrane (1) with the usual diffusive clearance rates (Cd), (similar to cuprophan dialyzer) giving increased total clearances (Ct = Cc + Cd) of small and middle molecules. Moreover, the improved biocompatibility of this dialyzer may improve dialytic tolerance, making for both elevated blood flows and high ultrafiltration rates. This cooperative study was designed to verify whether biofiltration is a suitable technique to shorten dialysis time.