High-flux dialyzer

High fidelity reproduction, lithographic resists and, 15 156 High flux dialyzers, 26 818 High frequency coreless induction furnace, 23 253... 

Environmental and iatrogenic exposure can result in aluminum overload in dialysis patients and evident osteomalacia, anemia and dementia [46]. Furthermore, acute intoxication with aluminum can lead to encephalopathy and death [47]. Hemoperfusion, hemodialysis, or hemofiltration combined with desferoxamine (DFO) can effectively remove aluminum [48]. Hemodialysis with a high flux dialyzer and hemofiltration are likely superior to charcoal hemoperfusion [48, 49]. In aluminum intoxicated dialysis patients, improvements in osteomalacia [50], anemia [51], and dementia [52] have been demonstrated with chelation. 

Fall in glomerular filtration rate in a rapid and dose related fashion if dose >1 g/m Charcoal hemoperfusion and sequential hemodialysis if severe renal toxicity (significant clearance of methotrexate can be achieved with high-flux dialyzers... 

It is noteworthy that a significant clearance of methotrexate can be achieved with high-flux dialyz-... 

Dialysis membranes are classified as conventional (standard), high-efficiency, and high-flux. Conventional dialyzers, mostly made of cuprophane, have small pores that limit clearance to relatively smaU molecules such as urea and creatinine. High-efficiency membranes have large surface areas and thus have a greater ability to remove water, urea, and other small molecules from the blood. High-flux... 

Matzke GR, Frye RF, Nolin TD. Vancomycin removal by low- and high-flux hemodialysis with polymethylmethacrylate dialyzers. J Am Soc Nephrol 1999 10 193A. 

Pressure Control of the Ultrafiltration Rate During Hemodialysis with High-Flux Dialyzers and the Time Dependence of Membrane Transport Parameters... 

In the counter-current mode the magnitude of this difference is set by the construction of the dialyzer and the dialysate pressure control and is generally on the order of 50 mm Hg or greater. This minimum pressure will induce an absolute minimum ultrafiltration rate of 350 ml/hr for a typical high flux membrane. Thus, when the patient has lost sufficient water or perhaps when he does not need to lose any water during dialysis, the patient must continuously be given sterile saline to make up for the minimum ultrafiltration loses. 

Figure 3. Patient monitoring system. This apparatus was assembled only to determine the dialyzer UF index, L,. Knowing Lp then allows safe high-flux dialysis without specialized equipment...

Ultrafiltration Results - Gambro High Flux Dialyzer... 

Data from two dialyses using the Gambro high flux dialyzer and three dialyses using the RP-610 dialyzer are depicted in Figure 5, 6 and 7. The decrease in L (called water permeability,... 

In Vivo Data for 1.36 m Gambro High Flux Dialyzer at Zero Ultrafiltration Rate and Blood Flow at 225 ml/mln... 

The results of this investigation which are clinically significant are 1) an accurate and simple means for controlling ultrafiltration during hemodialysis with "high flux" dialyzers has been developed, and 2) a formula which can accurately predict the ultrafiltration rate from measurement of hydrostatic pressures alone has been determined. It is now possible for any hemodialysis clinic to benefit from the use of high flux dialyzers by implementing the pressure control of ultrafiltration as described here. 

If sodium bicarbonate is used instead of acetate, no such fixation of metabolic C02 occurs and the gaseous C02 loss through the dialyzer is too small to cause significant hypocapnia and reciprocal hypoventilation and hypoxemia. However, a high bath bicarbonate concentration or the use of high-flux dialyzers will cause a large bicarbonate influx and rapid alkalemia, which would lead to alveolar hypoventilation and hypoxemia (C2). 

Fresh high-flux dialysis membranes achieve approximately 23—37% reductions in plasma P2M levels [344]. However, dialyzer reuse significantly impairs the removal of P2M [345]. Indeed, it has been recognized that non-specific adsorption of middle molecules on the surface of these synthetic high-flux membranes, rather than difiusion through the membrane, can account for significant amounts of the device s clearance [346, 347]. With the surface area of membranes in the dialysis device amounting to less than 2 m, the adsorption capacity of the device is obviously too small. 

The majority of patients with kidney disease are currently treated with dialyz-ers containing synthetic membranes with high-flux properties [20]. Figure 13.3 depicts changes in market shares for membrane flux and polymer type from the year 2000 to 2013 [21]. The figure shows that membrane polymers have evolved as part of a routine therapy, essentially in line with clinical observations and constantly changing clinical requirements [20]. 

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