CONTINUOUS REGENERATION OF PERITONEAL DIALYSATE BY A HYBRID ARTIFICIAL KIDNEY SYSTEM

通过混合人工肾系统连续再生腹膜透析液

• 批准号: 11650822
• 负责人: MINESHIMA Michio
• 金额: $ 2.18万
• 依托单位: TOKYO WOMEN'S MEDICAL UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1999
• 资助国家: 日本
• 起止时间: 1999 至 2002
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-11650822/
• 关键词: MEDICAL CHEMICAL ENGINEERING; ARTIFICIAL KIDNEY; PERITONEAL DIALYSIS; REGENERATION OF THE SPENT DIALYSATE; SPECIAL MACHINE; CANINE MODEL; SOLUTE REMOVAL EFFICIENCY; 膜分離; バイオリアクタ; 尿細管; 培養

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

为了提高传统腹膜透析(CPD)的溶质去除效率，本研究将开发一种利用新开发的人工肾小管的腹膜透析液再生系统。然而，人工肾小管还没有开发出来，因为肾小管的细胞依赖于几种操作条件，并且没有表现出稳定的孵化。另一方面，双向腹膜透析(BPD)作为一种新的腹膜透析系统被开发出来，用于再生用过的透析液。在BPD中，预定体积的腹膜透析液通过可逆泵在患者的腹膜腔和外部透析液储存器之间往复运动，使系统交替进入引流阶段和输液阶段。在引流阶段，透析液的一部分通过PD导管以100ml/min(Qdr)的速度排出并进入储液池。在输液阶段，容器中的透析液以300毫升/分钟(Qin)的速度返回到腹膜腔。在这两个阶段，附加透析器不断净化腹膜透析液。本研究在尿毒症犬模型上考察了BPD的溶质清除特性。BPD组和CPD组尿素下降率分别为20.0±7.2%(n=16)和3.5±3.6%(n=7)。肌酐也表现出类似的趋势。与传统的CAPD相比，BPD疗法的优点可以概括如下：a)溶质去除效率高)没有血管通路和抗凝剂c)使用的碳酸氢盐透析液的能力)通过减少交换减少蛋白质损失)通过体外循环进行药物输注的能力

项目成果

峰島 三千男: "次世代PD療法を展望する"腎と透析 別冊 2001,ハイパフォーマンスメンブレン'01,21世紀の末期腎不全医療を展望する. 51別冊. 22-25 (2001)

Michio Mineshima：“下一代 PD 治疗的展望”2001 年肾脏和透析特刊，高性能膜 01，21 世纪终末期肾病治疗的展望 51 特刊（2001 年）。

峰島 三千男: "腹膜透析から未来へのアプローチ"透析療法ネクスト. 1. 69-78 (2001)

峰岛道夫：“从腹膜透析走向未来”透析治疗下一篇。 1. 69-78 (2001)

Michio Mineshima: "Solute Removal Characteristics of Continuous Recirculating Peritoneal Dialysis in Experimental and Clinical Studies"ASAIO Journal 2000 : 46(1) ; 95-98. 46・1. 95-98 (2000)

峰岛道夫：“实验和临床研究中连续再循环腹膜透析的溶质去除特性”ASAIO Journal 2000：46(1)；46-98(2000)。

Michio Mineshima: "Solute Removal Charactccristics of Continuous Rccirculating Peritoneal Dialysisin Experimental and Clinical Studies"ASAIO Journal. (in press).

峰岛道夫：“实验和临床研究中连续循环腹膜透析的溶质去除特征”ASAIO 杂志。

峰島 三千男: "透析効率を高めるシステム技術-透析液再生型腹膜透析-"腎と透析 別冊、腹膜透析2002. 53(別冊). 59-61 (2002)

峰岛道夫：“提高透析效率的系统技术——透析液再生型腹膜透析——”肾脏与透析专卷，腹膜透析2002. 53(2002年)。