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      About Blood Purification: 3.0 Impact Factor I 5.6 CiteScore I 0.83 Scimago Journal & Country Rank (SJR)

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      Enhancement of Solute Removal in a Hollow-Fiber Hemodialyzer by Mechanical Vibration

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          Abstract

          Better solute clearance, particularly of middle-molecular-weight solutes, has been associated with improved patient outcomes. However, blood-membrane interaction during dialysis results in the development of secondary mass transfer resistances on the dialyzer membrane surface. We discuss the potential effects of mechanical vibration on the diffusion, convection and adsorption of uremic solutes during dialysis. For sinusoidal and triangular vibratory motions, we conceptualized the hemodynamic changes inside the membrane and consequent effects on membrane morphology. Longitudinal vibration generates reverse flow by relative membrane motion, and transverse vibration generates a symmetric swirling flow inside the hollow fiber, which enhances wall shear stress and flow mixing. Moreover, the impulse induced by triangle wave vibration could provide higher absorption capacity to middle-molecular-weight solutes. Mechanical vibration could enhance solute removal by minimizing membrane morphology changes resulting from blood-membrane interaction during hemodialysis. These effects of mechanical vibration can be helpful in extracorporeal blood purification therapies including continuous, portable and wearable systems.

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          Most cited references28

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          Self-diffusion of particles in shear flow of a suspension

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            Hemodialysis leukopenia. Pulmonary vascular leukostasis resulting from complement activation by dialyzer cellophane membranes.

            Acute leukopenia occurs in all patients during the first hour of hemodialysis with cellophanemembrane equipment. This transient cytopenia specifically involves granulocytes and monocytes, cells which share plasma membrane reactivity towards activated complement components. The present studies document that complement is activated during exposure of plasma to dialyzer cellophane, and that upon reinfusion of this plasma into the venous circulation, granulocyte and monocyte entrapment in the pulmonary vasculature is induced. During early dialysis, conversion of both C3 and factor B can be demonstrated in plasma as it leaves the dialyzer. Moreover, simple incubation of human plasma with dialyzer cellophane causes conversion of C3 and factor B, accompanied by depletion of total hemolytic complement and C3 but sparing of hemolytic C1. Reinfusion of autologous, cellophane-incubated plasma into rabbits produces selective granulocytopenia and monocytopenia identical to that seen in dialyzed patients. Lungs from such animals reveal striking pulmonary vessel engorgement with granulocytes. The activated complement component(s) responsible for leukostasis has an approximate molecular weight of 7,000-20,000 daltons. Since it is generated in C2-deficient plasma and is associated with factor B conversion, it is suggested that activation of complement by dialysis is predominantly through the altermative pathway.
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              Theory of concentration polarization in crossflow filtration

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                Author and article information

                Journal
                BPU
                Blood Purif
                10.1159/issn.0253-5068
                Blood Purification
                S. Karger AG
                0253-5068
                1421-9735
                2011
                June 2011
                14 January 2011
                : 31
                : 4
                : 227-234
                Affiliations
                aDepartment of Nephrology, San Bortolo Hospital, and bInternational Renal Research Institute Vicenza, Vicenza, Italy; cInstitute of Medical and Biological Engineering, Medical Research Center, Seoul National University, dInterdisciplinary Program of Bioengineering Major, Seoul National University, eDepartment of Internal Medicine, Chung-Ang University Hospital, and fDepartment of Biomedical Engineering, College of Medicine, Seoul National University, Seoul, Korea; gNephrology Department, Selayang Hospital, Selangor, Malaysia
                Author notes
                *Claudio Ronco, MD, Department of Nephrology, San Bortolo Hospital, Viale Rodolfi 37, IT–36100 Vicenza (Italy), Tel. +39 0444 753 650, Fax +39 0444 753 973, E-Mail cronco@goldnet.it
                Article
                321073 Blood Purif 2011;31:227–234
                10.1159/000321073
                21242675
                65ce0c33-9212-4b31-a430-8ea549fa9554
                © 2011 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                : 07 July 2010
                : 07 September 2010
                Page count
                Figures: 4, Pages: 8
                Categories
                In-Depth Review

                Cardiovascular Medicine,Nephrology
                Diffusion,Convection,Concentration polarization,Vibration,Mechanical stress,Hemodiafiltration,Adsorption,Membrane fouling,Hemofiltration

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