Ultrafiltration during hemodialysis, controlling

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. 

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

Hypotension is common during hemodialysis. When it occurs early (within the first half hour), it may be due to overmedication with antihypertensive agents, pericardial effusion, or the first-use syndrome. Later in dialysis hypotension usually results from excessive ultrafiltration, abnormal left ventricular fiinction, or the peripheral vasodilatory effect of acetate in the dialysis bath. Prevention depends on the cause of hypotension. It includes the administration of saline intravenously, controlling the rate of ultrafiltration, increasing the dialysate sodium concentration to about 140 mEq/liter, or substituting bicarbonate for acetate in the dialysis bath (B22). 

Hemodialysis/hemofiltration alone had sales of over US 2200 million in 1998. Reverse osmosis (RO), ultrafiltration (UF) and microfiltration (MF) together accounted for 1.8 billion dollars in sales in 1998. At that time about US 400 million worth of membranes and modules were sold each year worldwide for use in reverse osmosis. About 50% of the RO market was controlled by Dow/FihnTec and Hydranautics/Nitto. They were followed by DuPont and Osmonics. Membranes are apphed during sea-water desahnation, municipal/ brackish water treatment and in the industrial sectors. The market for RO and nanofiltration is growing at a rate higher than 10%/year. The market for desali-... 

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