| [ Summary ] |
Since 1985, many dialyzers have been designed, to be of the high-flux type to remove large solutes such as β2-micrglobulin (β2MG). The resistance of dialysis membranes must be considered. The resistance of film layers outside of membranes and inter-compartmental resistance in the body must also be kept in mind. In addition to the design of dialysis membranes capable of removing β2MG, hollow fiber diameter and module designs have been optimized to maximize large solute transport by utilizing internal filtration. Internal filtration of dialyzers plays an extremely large role in increments of β2MG clearance. Patients receiving convective treatments such as on-line HDF account for 13 % of all dialysis patients in Japan, as of the end of 2014. By utilizing HDF, it is possible to achieve 80 % efficacy in terms of β2MG removal rates, and to remove larger solutes than with β2MG. Filtration processes are certain to create concentration-polarization phenomena and to cause membrane fouling. In cases of targeted molecules larger than β2MG, control of transmembrane pressure has become important in separating large molecules from albumin. |