Effects of fiber length and filling rate on reduction rate of serum low molecular weight proteins: In vitro and clinical evaluation for a newly developed dialyzer housing

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  • 中空糸有効長と中空糸充填率は低分子蛋白の除去能に作用するか

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A new polysulfone dialyzer (BS-1.6UL: BSL), characterized by a longer fiber length and an increased fiberfilling rate, has recently been developed by Toray Medical Co, Ltd (Tokyo, Japan). To determine the significance of the fiber length and the filling rate, the reduction rates of serum low molecular weight proteins were compared among BSL and two conventional dialyzers. The dialyzers tested were BSL, BS-1.6U (BSU, Toray) with a shorter fiber length compared to BSL, and PS-1.6UW (PSW, Kawasumi, Tokyo, Japan), a polysulfone dialyzer with a fiber length similar to that of BSL. In in vitro studies, discarded plasma from end stage renal disease (ESRD) patients and familial hypercholesterolemia patients were dialyzed in a recirculation batch system. The subjects of the clinical studies consisted of six ESRD patients. Both in vitro and clinical studies showed that the reduction rate of low molecular weight proteins was higher in BSL than in other dialyzers, whereas the reduction rate of small molecular substances were similar among the three dialyzers. Adsorption of small proteins and lipids did not significantly differ among the three dialyzers. Leukocyte and platelet counts, and the C3a levels of patients during dialysis did not significantly differ among the three dialyzers. Pressure drop was significantly higher in BSL (BSL>PSW>BSU) both in blood and dialysate compartments. Our results suggest that a longer fiber length and an increased fiber filling rate in dialyzer housing is efficient for the removal of low molecular weight proteins. The efficiency is presumably attributable to the inner filtration rate of the fiber accomplished by the high blood pressure drop in the blood and dialysate compartments.

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