Blood-Membrane Interactions During Dialysis
Blood-Membrane Interactions During Dialysis
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DOI：
10.1111/j.1525-139x.2009.00658.x
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发表时间：
2009-11-01
影响因子：
1.6
通讯作者：
Clark, William R.
中科院分区：
文献类型：
--
作者：
Huang, Zhongping;Gao, Dayong;Clark, William R.
在体外肾脏替代治疗中，透析器不仅是发生溶质去除的部位，而且是暴露于血液的表面积最大的体外回路组件。因此，血液成分和透析器膜之间的相互作用以多种方式影响透析程序并不奇怪。基于工程原理，流体沿着表面（例如膜）流动导致边界层的发展，该边界层可影响溶质去除。此外，血液暴露于任何体外人工表面导致体内几种途径的激活，包括涉及凝血和补体激活的那些途径。这种广义活化过程的副产物之一是蛋白质吸附到膜表面，这是另一种对溶质去除有显著影响的现象。在这篇文章中，血液膜相互作用的方式影响溶质清除血液透析和相关治疗提供了详细的审查。详细讨论了二次膜形成和边界层/浓差极化效应对溶质去除的影响。此外，吸附作为一种特定的去除机制，低分子量蛋白质的高渗透性的合成膜的重要性突出。
In extracorporeal renal replacement therapies, the dialyzer is not only the site at which solute removal occurs but also the extracorporeal circuit component having the largest surface area exposed to blood. Therefore, it is not surprising that interactions between blood components and the dialyzer membrane influence the dialysis procedure in several ways. Based on engineering principles, fluid flow along a surface such as membrane results in the development of a boundary layer which can influence solute removal. Furthermore, the exposure of blood to any extracorporeal artificial surface results in the activation of several pathways within the body, including those involving coagulation and complement activation. One of the byproducts of this generalized activation process is protein adsorption to the membrane surface, another phenomenon which can have a significant impact on solute removal. In this article, a detailed review of the ways in which blood-membrane interactions influence solute removal during hemodialysis and related therapies is provided. The influences of secondary membrane formation and boundary layer/concentration polarization effects on solute removal are specifically discussed. Furthermore, the importance of adsorption as a specific removal mechanism for low-molecular weight proteins by highly permeable synthetic membranes is highlighted.