CONTINUOUS REGENERATION OF PERITONEAL DIALYSATE BY A HYBRID ARTIFICIAL KIDNEY SYSTEM

在这项研究中，使用新开发的人工肾小管的腹膜腔废透析液的再生系统将被开发，以提高传统腹膜透析（CPD）的溶质去除效率。然而，人工肾小管尚未开发，因为肾小管细胞依赖于几种操作条件，并且没有显示出稳定的孵育。另一方面，双向腹膜透析（BPD）作为一种新的腹膜透析系统，已被开发用于再生废透析液。在BPD中，预设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液器之间往复运动，使系统交替地处于引流阶段和输注阶段。在引流阶段，一部分滞留透析液以100 ml/min（QDR）通过PD导管引流并进入储液器。在输注阶段，储液器中的透析液以300 ml/min（QIN）返回腹膜腔。在这两个阶段，附加透析器持续净化腹膜透析液。在这项研究中，BPD的溶质清除特性进行了研究，在尿毒症犬模型。BPD和CPD的尿素减少率分别为20.0 ± 7.2%（n=16）和3.5 ± 3.6%（n=7）。克雷蒂安也表现出类似的倾向。与传统CAPD相比，BPD治疗的优势可总结如下：a）溶质清除效率高b）无血管通路且无抗凝剂c）使用碳酸氢盐透析液的能力）通过减少交换降低蛋白质损失e）通过体外回路进行药物输注的能力

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