Dialysis Membrane Manipulation for Endotoxin Removal

Henrie, Michael; Ford, Cheryl; Stroup, Eric; Ho, Chih-Hu

doi:10.5772/22910

Cited by 2 publications

(4 citation statements)

References 83 publications

(74 reference statements)

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“…A model of in vitro dialysis previously described was modified for this study (Figure ) . Standard dialysis cassettes for clinical use were used for the in vitro studies ( n = 3).…”

Section: Methodsmentioning

confidence: 99%

“…Blood is passed through the fiber lumen while dialysate is circulated in a tangential flow outside of the fiber bundles. As blood toxins diffuse into the dialysate it is also possible for any impurities in the dialysate to enter the blood through back‐filtration—this is of particular concern for dialysate contaminated with bacterial endotoxin, or lipopolysaccharide (LPS) . Use of high‐flux dialyzers, which remove large percentages of middle molecular weight toxins such as β 2 ‐microglobulin (MW 11 kDa), further raises the potential of back‐filtration of LPS in contaminated dialysate …”

Section: Introductionmentioning

confidence: 99%

“…Several materials and membrane chemical compositions have been studied for their ability to limit LPS back filtration either in preultrafiltration stages or directly during dialysis treatment. Among these are: polysulfone (PS), polyamide, cellulosic tri‐acetate, ceramic, and polyester . Reduced back‐filtration has been ascribed primarily to LPS adsorption, with filtration also playing a significant role .…”

Section: Introductionmentioning

confidence: 99%

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Hemodialysis membrane surface chemistry as a barrier to lipopolysaccharide transfer

Madsen

Britt

et al. 2014

J of Applied Polymer Sci

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During hemodialysis bacterial lipopolysaccharide (LPS) in contaminated dialysate solution may translocate across the hollow fiber membrane (HFM) to a patient's blood, resulting in fever and possible systemic shock. This study investigates LPS transfer across, and adsorption within, native and modified Fresenius Optiflux® F200NRe polysulfone (PS)/polyvinyl pyrrolidone (PVP) HFMs. Modifications include varied PVP content, addition of a PS‐poly(ethylene glycol) copolymer (PS‐PEG), and bleach sterilization. Under clinically relevant flow conditions LPS from >400 EU mL−1 spiked dialysate is not detected (<0.1 EU mL−1) in the lumens of native fibers, but is detected to varying degrees (0.2–15 EU mL−1) in the lumens of the modified fibers. Fluorescently labeled LPS predominantly adsorbs near the lumen of all membranes except the PS‐PEG containing membrane, where LPS localizes on the outer wall. Thus, addition of PS‐PEG may entrap LPS in the HFM spongy matrix, away from the blood‐contacting fiber lumen. © 2014 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2015, 132, 41550.

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“…A model of in vitro dialysis previously described was modified for this study (Figure ) . Standard dialysis cassettes for clinical use were used for the in vitro studies ( n = 3).…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Hemodialysis membrane surface chemistry as a barrier to lipopolysaccharide transfer

Madsen

Britt

et al. 2014

J of Applied Polymer Sci

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“…Increasing the removal of middle molecules by increasing diffusion and convection must be balanced against the transport of pyrogenic bacterial products from the dialysate to the blood [ 49 ]. The materials used in contemporary membranes retain endotoxins and other bacterial products by adsorption, which offers a size-independent retention mechanism in addition to the size exclusion mechanism of the membrane.…”

Section: Approaches To the Development Of New Membranesmentioning

confidence: 99%

Membrane innovation: closer to native kidneys

Storr

Ward²

2018

Nephrology Dialysis Transplantation

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Modern methods in analytical biochemistry have established that uraemia is associated with the retention of proteins, both in their native state and post-translationally modified, over a wide range of molecular weights up to 60 kDa. Evidence is accumulating that these higher molecular weight retention solutes are important uraemic toxins, and therapies such as online haemodiafiltration (HDF), which enhance their removal, are associated with improved outcomes. However, HDF has limitations regarding cost, clinical implementation and the need for an external source of sterile substitution solution to maintain fluid balance. New membranes that have a solute removal profile more closely approaching that of the glomerular filtration barrier when used for conventional haemodialysis, while at the same time not allowing the passage of clinically significant amounts of beneficial proteins, are needed to address these limitations. Tighter control of the molecular characteristics of the polymers used for membrane fabrication, along with the introduction of additives and improvements in the manufacturing process, has led to membranes with a tighter pore size distribution that allows the use of an increased absolute pore size without leaking substantial amounts of albumin. At the same time, the wall thickness and internal diameter of membrane fibres have been decreased, enhancing convective transport within the dialyser without the need for an external source of substitution solution. These new expanded range membranes provide a solute removal profile more like that of the native kidney than currently available membranes when used in conventional haemodialysis.

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Dialysis Membrane Manipulation for Endotoxin Removal

Cited by 2 publications

References 83 publications

Hemodialysis membrane surface chemistry as a barrier to lipopolysaccharide transfer

Hemodialysis membrane surface chemistry as a barrier to lipopolysaccharide transfer

Membrane innovation: closer to native kidneys

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