Theme |
The Front of Dialysate Purification Technologies in Hemodialysis Therapy |
Title |
Relationship between dialyzer performance and quality control for dlialysates |
Author |
Michio Mineshima |
Department of Clinical Engineering, Tokyo Women's Medical University |
[ Summary ] |
Internal filtration flow rates (QIF) in dialyzers have increased with dialyzer performance improvements in recent years. Increasing backfiltration means increasing the risk of invasion of endotoxin fragments in the dialysate into the patient's blood. Strict management of quality control for dialysates is required especially with internal filtration enhanced hemodialysis (IFEHD), defined as a form of HD therapy. This therapy employs a dialyzer designed for enhanced internal filtration / backfiltration (IF / BF). This dialyzer was introduced to have a higher solute removal efficiency than that in conventional HD since enhanced IF / BF flow rates have increased the convective transport of solutes in addition to diffusive transport. The QIF value of all dialyzers should be evaluated by a simple estimation method based on an ultrafiltration coefficient, UFRP, and transmembrane pressure. Dialyzers for each patient should be selected, taking into consideration the level of quality control for dialysates in that dialysis unit. |