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      Efficiency of Different Hollow-Fiber Hemofilters in Continuous Arteriovenous Hemodiafiltration

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          Abstract

          Low dialysate to blood flow rate ratios are a unique characteristic of continuous arteriovenous hemodiafiltration (CAVHDF) that should allow complete saturation of dialysis fluid with small-molecular-weight blood solutes. The aim of the investigation was to evaluate the performance of different hemofilters in CAVHDF. In 10 critically ill patients with acute renal failure, the efficiency of four hollow-fiber hemofilters, polyamide 0.6 m<sup>2</sup>, polyacrylonitrile (PAN) 0.3 and 0.6 m<sup>2</sup>, acrylonitrile sodium methallylsulfonate (AN69HF) 0.6 m<sup>2</sup>, has been evaluated. For comparison, dialysate flow rates (Q<sub>di</sub>) were standardized to 16.6 and 25 ml/min. Samples for urea nitrogen were obtained from the arterial blood line (C<sub>bi</sub>) and from the dialysate exit port (C<sub>do</sub>) within 24-hour running time. Outflowing dialysate (Q<sub>do</sub>) was also measured at the same time. Blood flow (Q<sub>b</sub>) was calculated by the bubble transit time technique. Diffusive and total urea clearances were determined. AN69HF and PAN hemofilters provided higher clearances than the polyamide hemofilter. Despite the smaller surface area, PAN 0.3 m<sup>2</sup> had a total urea clearance comparable to that of PAN 0.6 m<sup>2</sup> and AN69HF at Q<sub>di</sub> = 16.6 ml/min. While at Q<sub>di</sub> = 16.6 ml/min equilibrium between blood and dialysate (C<sub>do</sub>/C<sub>bi</sub> ≅ 1) occurred with the AN69HF and PAN hemofilters, at Q<sub>di</sub> = 25 ml/min the equilibrium was obtained only with the AN69HF hemofilter. In conclusion, almost complete urea saturation of dialysis fluid has not been obtained with all hemofilters tested here. In our experience, membrane characteristics play an important role in determining diffusive efficiency in CAVHDF.

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          Author and article information

          Journal
          AJN
          Am J Nephrol
          10.1159/issn.0250-8095
          American Journal of Nephrology
          S. Karger AG
          0250-8095
          1421-9670
          2000
          April 2000
          19 April 2000
          : 20
          : 2
          : 116-121
          Affiliations
          aDivision of Nephrology and bDepartment of Cardiac Surgery, Policlinico Umberto I, University ‘La Sapienza’, Rome, Italy
          Article
          13567 Am J Nephrol 2000;20:116–121
          10.1159/000013567
          10773611
          © 2000 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.

          Page count
          Figures: 2, Tables: 2, References: 20, Pages: 6
          Product
          Self URI (application/pdf): https://www.karger.com/Article/Pdf/13567
          Categories
          Clinical Study

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