Evaluation of solute clearance and sequential filtration of 5 different hemofilters used for continuous hemodiafiltration in critically ill patients

DOI 3 References
  • Yamashita Yoshihisa
    School of Biomedical Engineering, Faculty of Health and Medical Care, Saitama Medical University
  • Tsukamoto Isao
    Department of Medical Engineering, International Medical Center, Saitama Medical University
  • Murasugi Hiroshi
    Department of Medical Engineering, International Medical Center, Saitama Medical University
  • Ohama Kazuya
    Division of Blood Purification, Saitama Medical University Hospital
  • Sugahara Souichi
    Department of Nephrology, Saitama Medical University Hospital
  • Suzuki Hiromichi
    Department of Nephrology, Saitama Medical University Hospital

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  • 持続的血液濾過透析に使用する5つの血液濾過器の臨床評価

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Hemofilters for continuous hemodiafiltration (CHDF) have been expected not only long lifetime but also high clearance capacity of low molecular proteins, which may cause multiple organ dysfunction syndrome (MODS). To evaluate commercially available hemofilters for CHDF, 18 critically ill patients with renal failure were randomly assigned to receive one of five commercial hemofilters; Panflo APF-06S (APF, Asahikasei Medical), PS filter C07 (PS, Kuraray Medical), Hemofeel CH-0.6L (Toray Medical), UT filter UT-700S (Nipro), and Hemofeel SH-0.8 (SH, Toray Medical); whose membranes were made of polyacrylonitrile, polysulfone, polymethyl methacrylate, cellulose triacetate, and polysulfone, respectively. Solute clearance and sequential ultrafiltration rate were determined. Clearances of small solutes (urea and creatinine) were not significantly different among these hemofilters and did not decrease throughout 24 hours. Clearances of low molecular proteins (β2 microglobulin, myoglobin, and interleukin-6) by APF and PS were higher than the others, and scarcely decreased even at 24 hours after. All filters were insufficient to remove α1 microglobulin, molecular weight of 33 kDa, and no filters leaked albumin. Both APF and SH showed higher ultrafiltration rates and longer lifetime over 24 hours than the others. These results suggest that APF may be the best hemofilter for CHDF in the treatment of critically ill patients with renal failure.

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