CONTINUOUS REGENERATION OF PERITONEAL DIALYSATE BY A HYBRID ARTIFICIAL KIDNEY SYSTEM

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In this study, a regeneration system for the spent dialysate of the peritoneal cavity using newly developed artificial renal tubules would be developed to improve the solute removal efficiency of the conventional peritoneal dialysis (CPD). Artificial renal tubules, however, have not been developed because the cells of renal tubules depended on several operating conditions and have showed no stable incubation. On the other hand, Bi-directional Peritoneal Dialysis (BPD) has been developed to regenerate the spent dialysate as a new peritoneal dialysis system. In the BPD, a preset volume of the peritoneal dialysate reciprocates between the patient's peritoneal cavity and a outside dialysate reservoir by a reversible pump, giving the system a drain phase and an infusion phase alternatively. In the drain phase, a part of the dwelt dialysate is drained through the PD catheter at 100 ml/min (QDR) and enters the reservoir. In the infusion phase, the dialysate in the reservoir is returned to the peritoneal cavity at 300 ml/min (QIN). In both phases, the add-on dialyzer purifies the peritoneal dialysate continually. In this study, solute removal characteristics of BPD were examined in uremic canine model. The urea reduction rate in BPD and CPD were 20.0 ± 7.2%(n=16) and 3.5 ± 3.6%(n=7), respectively. Creatinine showed a similar tendency. The advantages of BPD therapy in comparison with conventional CAPD can be summarized as follows :a) High efficiency for solute removalb) No vascular access and no anticoagulantc) Capability for bicarbonate dialysate usaged) Low protein loss by reducing the exchangese) Capability for drug infusion through the extracorporeal circuit