酢酸セルロース膜の低分子蛋白除去特性と生体適合性に関する臨床的研究

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  • Studies on the removal rate of low molecular weight protein and the biocompatibility of cellulose triacetate membrane for hemodialysis.

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During 4hr of isovolemic hemodialysis (HD), we employed a cellulose triacetate membrane (CTA membrane, 1.1m2), which is thought to remove β2-microglobulin (β2-MG) mainly by diffusion, to estimate the removal of β2-MG by the diffusion alone, sieving coefficient (SC) of several marker proteins, kinetics of acute phase reactant (APR) and biocompatibility.<br>The removal rate of β2-MG by diffusion alone was 39.7% (mean). The SC of several marker proteins were as follows: β2-MG=0.607, myoglobin=0.476, α1-antitrypsin=0.005, albumin=0.003.<br>The biological effect of the CTA membrane, as evaluated by the response of APR including CRP and by indicators of biocompatibility including PaO2, WBC count and complement, was that APR was not increased during the course of observation but that a mild, transient decrease in WBC count was observed in the early phase of HD therapy.<br>To assess the most appropriate mode of therapy, we compared the summation effect of convection (3kg, 8kg) and diffusion alone with the removal rate of β2-MG by diffusion alone.<br>The removal rate of 3kg convection plus diffusion was 57.5% (mean). There was no statistically significant difference between 3kg and 8kg convection.<br>Therefore, it may be concluded that the application of the CTA membrane (1.1m2) for regular HD therapy is more useful than that for hemodiafiltration, but further investigation, especially with a larger CTA membrane is required.

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