No abstract

Some dialysis patients are treated with post-hemodiafiltration (HDF); the blood viscosity of the patients who undergo post-HDF is higher than that of the patients who undergo conventional hemodialysis. This study aims to evaluate poly(N-vinyl-2-pyrrolidone) (PVP) elution from PSf dialysis membranes by varying solvents and high wall shear stress caused by blood viscosity. We tested three commercial membranes: APS-15SA (Asahi Kasei Kuraray), CX-1.6U (Toray) and FX140 (Fresenius). Dialysate and blood sides of the dialyzers were primed with reverse osmosis (RO) water and saline. RO water, saline and dextran solution (2.9 and 5.8 mPa s) were circulated in the blood side. The amount of eluted PVP was determined by 0.02 N iodometry. The hardness and adsorption force of human serum albumin (HSA) on the membrane surfaces were measured by the atomic force microscope. When wall shear stress was increased using dextran, the amount of PVP eluted by the 2.9 mPa s solution equaled that eluted by the 5.8 mPa s solution with APS-15SA and CX-1.6U sterilized by gamma rays. The amount of PVP eluted by the 5.8 mPa s solution was higher than that eluted by the 2.9 mPa s solution with FX140 sterilized by autoclaving. The wall shear stress increased the PVP elution from the surface, hardness and adsorption force of HSA. Sufficient gamma-ray irradiation is effective in decreasing PVP elution.

The objective of this study was to evaluate the effect of protracted storage of dialyzers on the amount of poly(N-vinyl-2-pyrrolidone) (PVP) eluted from polysulfone-group dialysis membranes. We tested five dialysis membranes: APS-15SA (Asahi Kasei Kuraray, wet), CX-1.6U (Toray, moist), FX140 (Fresenius, dry), PES-15Sα (Nipro, dry), and FDX-150GW (Nikkiso, wet). Each dialyzer was stored for 1, 3, 14, and 18 months after sterilization. The dialysis-fluid side compartment was primed with reverse osmosis (RO) water at 500 mL/min for 5 min at 310 K. The blood side compartment was primed with RO water at 200 mL/min for 5 min at 310 K. Finally, 1 L RO water was circulated through the blood side compartment at 200 mL/min for 4 h at 310 K. Eluted PVP was determined by use of the iodine method, using 0.02 N: iodine solution. PVP was mainly eluted from wet-type dialyzers during priming. Thus, the standard 5 min priming of the wet-type dialyzer according to the maker manual inhibits PVP elution during circulation. PVP was eluted in the dialysis-fluid side of the moist-type dialyzer during priming but no PVP was eluted in the blood side. PVP was mainly eluted from dry-type dialyzers during circulation. We recommend more than the standard 5 min priming, particularly for dry-type dialyzers stored for protracted periods, because 5 min insufficient to inhibit PVP elution during circulation.

The objective of the present study was to evaluate the characteristics of protein adsorption on the inner surface of various dialysis membranes, to develop protein adsorption-resistant biocompatible dialysis membranes. The adsorption force of human serum albumin (HSA) on the inner surface of a dialysis membrane and the smoothness of the membrane were evaluated from a nanoscale perspective by atomic force microscopy. The content ratio of the hydrophilic polymer, polyvinylpyrrolidone (PVP), was determined by attenuated total reflection Fourier transform infrared spectroscopy. Nine synthetic-polymer dialysis membranes on the market made of polysulfone (PSF), polyethersulfone (PES), polyester polymer-alloy (PEPA), and ethylene vinylalcohol (EVAL) were used in the present study. The HSA adsorption force on the surface of the hydrophobic polymer PEPA membrane was higher than that on the hydrophilic polymer EVAL membrane surface. It has been considered beneficial, for decreasing the HSA adsorption force, to cover a hydrophobic polymer membrane surface with PVP. However, there were some areas on PVP-containing membrane surfaces at which much higher HSA adsorption forces were observed. The HSA adsorption force gave a nearly linear correlation with the surface roughness on the PSF membrane surface. However, the HSA adsorption force was uncorrelated with the PVP content ratio for any of the PSF membrane surfaces tested. In conclusion, protein adsorption can be minimized by the use of dialysis membranes made of hydrophobic polymers containing PVP with a smooth surface.

This report describes the compositional and structural design strategy of a zeolite-polymer composite nanofiber mesh for the efficient removal of uremic toxins towards blood purification application. The nanofiber is fabricated by electrospinning composite solution of biocompatible poly(ethylene-co-vinyl alcohol) (EVOH) and zeolite particles which are capable of selectively adsorbing uremic toxins such as creatinine. By controlling electrospinning conditions carefully, the incorporated zeolites in EVOH were found to correspond closely to the feed ratios. Elemental mapping images of Si show that zeolites were uniformly blended within the fibers. The fabricated composite fibers successfully adsorbed creatinine from solution and the adsorption capacity reached a maximum at 12 h. The crystallinity of the nanofiber was also controlled by varying the composition of ethylene content in EVOH. Less crystallinity resulted in higher creatinine adsorption capacity due to the barrier property of EVOH. Cytotoxicity assay demonstrated that the composite fibers showed less toxicity than free zeolite particles which killed more than 95% of cells. The proposed composite fibers, therefore, have the potential to be utilized as a new approach to removing creatinine selectively from the bloodstream.