Novel MCO high-flux membranes for hemodialysis have been developed with optimized permeability, allowing for filtration close to that of the natural kidney. A comprehensive in vitro characterization of the membrane properties by dextran filtration is presented. The sieving profile of pristine membranes, as well as that of membranes exposed to blood for 40 minutes, are described. The effective pore size (Stokes-Einstein radius) was estimated from filtration experiments before and after blood exposure, and results were compared to hydrodynamic radii of middle and large uremic toxins and essential proteins. The results indicate that the tailored pore sizes of the MCO membranes promote removal of large toxins while ensuring the retention of albumin.

Hydroxyl functionalized multi-walled carbon nanotubes (MWCNTs) were blended with Polyacrylonitrile (PAN) to prepare ultrafiltration membranes by a phase inversion process. Three different concentrations of MWCNTs were used in PAN, i.e. 0.5, 1 and 2 wt%. The water flux of the membranes increased by 63% at 0.5 wt% loading of MWCNTs compared to neat PAN membranes. The water flux decreased upon further increase in the concentration of MWCNTs, but at 2 wt% loading it was still higher compared to pure PAN membranes. The surface hydrophilicity of the membranes was enhanced upon the addition of MWCNTs, as observed by contact angle measurements. The increased hydrophilicity might have an impact on the improved water flux. All the membranes showed a molecular weight cut off (MWCO) of approximately 50 Kg/mol. Surface pore size analysis by scanning electron microscopy (SEM) showed no significant difference in the mean pore size of the nanocomposite membranes compared to the neat membranes. The cross section morphology was influenced by the introduction of MWCNTs where less but enlarged macrovoids were observed, particularly prominent at a loading of 2 wt% MWCNTs. The membranes containing 2wt% MWCNTs showed 36% improvement in resistance against compaction compared to neat membranes. Furthermore, the tensile strength of the membranes at 2wt% MWCNTs loading increased over 97% compared to neat ones.

High cut-off membranes are a new class of blood purification membranes whose particular characteristics present challenges for commonly-used characterization methods. Dextran sieving curves for representative blood purification membranes of the high-flux and high cut-off types were measured and compared to curves for the glomerular filtration barrier (GFB). The performance was also determined after blood exposure for the most permeable synthetic membranes. High cut-off membranes were observed to be more open than the GFB before blood exposure, but become tighter and more selective after the exposure, keeping the permeation for low and middle molecules while restraining the filtration of large species. Based on dextran sieving experiments for a variety of commercially available blood purification membranes, we present a novel method for classifying blood purification membranes. By using a well-established technique and introducing a new characteristic parameter for the sieving curve--the molecular weight retention onset (MWRO)--a graph of molecular weight cut-off versus molecular weight retention onset provides the landscape of dialysis membrane types. This meaningful representation is based on only one in vitro method, and allows the membrane classification by indirectly considering two structural parameters: pore size and pore size distribution. In this way, the families of low-flux, high-flux, protein leaking, and high cut-off membranes are clearly differentiated. The differentiation allows for the definition of MWCO/MWRO regions for the different types, so that further classification of newly developed membranes can be easily achieved.

Background: Membranes with increasing pore size are introduced to enhance removal of large uremic toxins with regular hemodialysis. These membranes might theoretically have higher permeability for bacterial degradation products. In this paper, permeability for bacterial degradation products of membranes of comparable composition with different pore size was investigated with a new in vitro set-up that represents clinical flow and pressure conditions. Methods: Dialysis was simulated with an AK200 machine using a low-flux, high-flux, medium cut-off (MCO) or high cut-off (HCO) device (n = 6/type). A polyvinylpyrrolidone-solution (PVP) was recirculated at blood side. At dialysate side, a challenge solution containing a filtrated lysate of two water-borne bacteria (Pseudomonas aeruginosa and Pelomononas saccharophila) was infused in the dialysate flow (endotoxin ≥ 4EU/ml). Blood and dialysate flow were set at 400 and 500 ml/min for 60 min. PVP was sampled before (PVP pre ) and after (PVP post ) the experiment and dialysate after 5 and 55 min. Limulus Amebocyte Lysate (LAL) test was performed. Additionally, samples were incubated with a THP-1 cell line (24 h) and IL-1β levels were measured evaluating biological activity.