Modeling of Internal Filtration in Theranova Hemodialyzers
Modeling of Internal Filtration in Theranova Hemodialyzers
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DOI：
10.1159/000479261
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发表时间：
2017-01-01
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影响因子：
--
通讯作者：
Ronco, Claudio
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作者：
Lorenzin, Anna;Neri, Mauro;Ronco, Claudio
高截留起始（HRO）是一类新的血液透析膜的名称。该类的独特特征是高度选择性和可控的孔隙率，导致筛分性能，在中/大分子量溶质清除和白蛋白损失之间提供临床所需的平衡。这种膜类的另一个定义特征是相对小的纤维直径，其以内部过滤的形式产生高对流体积。本研究的目的是通过半经验方法估计2种新型HRO透析器：Theranova 400和Theranova 500（巴克斯特国际公司，Deerfield，IL，USA）。轴向血液和透析液室压降沿着以及跨膜压，在体外用血液测量（Q（B）= 300或400 mL/min; Q（d）= 500 mL/min;净超滤率= 0），用作3种不同模型的输入参数：线性、几何和（非线性）数学。基于最严格的数学模型，Theranova 400的估计对流体积为1，661 mL/h（Q（B）= 300 mL/min）和1，911 mL/h（Q（B）= 400 mL/min），Theranova 500的估计对流体积为1，864 mL/h（Q（B）= 300 mL/min）和1，978 mL/h（Q（B）= 400 mL/min）。这些结果表明，这种新型膜的独特纤维特性提供了大量的对流体积，而无需外源性置换液。因此，HRO膜是寻求增强较大尺寸尿毒症毒素去除的主要终末期肾病治疗进展。(c)2017 S. Karger AG，巴塞尔
High retention onset (HRO) is the designation for a new class of hemodialysis membranes. A unique characteristic of this class is the highly selective and controlled porosity resulting in sieving properties that provide a clinically desirable balance between middle/large molecular weight solute removal and albumin loss. Another defining feature of this membrane class is the relatively small fiber diameter, which produces high convective volumes in the form of internal filtration. The aim of the present study was to estimate, by semi-empirical methods, convective volumes for 2 new HRO dialyzers: Theranova 400 and Theranova 500 (Baxter International Inc., Deerfield, IL, USA). Axial blood and dialysate compartment pressure drop along with transmembrane pressure, measured in vitro with blood (Q(b) = 300 or 400 mL/min; Q(d) = 500 mL/min; net ultrafiltration rate = 0), served as input parameters for 3 different models: linear, geometric, and (non-linear) mathematical. Based on the most rigorous mathematical model, the estimated convective volumes were 1,661 mL/h (Q(b) = 300 mL/min) and 1,911 mL/h (Q(b) = 400 mL/min) for Theranova 400 and 1,864 mL/h (Q(b) = 300 mL/min) and 1,978 mL/h (Q(b) = 400 mL/min) for Theranova 500. These results suggest that the unique fiber characteristics of this new class of membranes provide substantial convective volumes without the need for exogenous substitution fluid. As such, HRO membranes are a major end-stage renal disease treatment advance in the quest to enhance the removal of larger-sized uremic toxins. (c) 2017 S. Karger AG, Basel