The haemodialysis system: basic mechanisms of water and solute transport in extracorporeal renal replacement therapies

Ronco, Claudio; Ghezzi, P; Brendolan, Alessandra; Crepaldi, Carlo; Greca, G. La

doi:10.1093/ndt/13.suppl_6.3

Cited by 59 publications

(36 citation statements)

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“…Also, for a given solute, an increase in either membrane permeability ( K O ) or area ( A ) has an effect on increasing both the transition Q B and the plateau clearance value ( Fig. 4 ) [9] . As demonstrated in Figure 4 , dialyzers having surface areas of 2.0 m 2 or more require Q B values of at least 400 mL/min to achieve peak operational efficiency.…”

Section: Blood Compartmentmentioning

confidence: 97%

“…In contemporary HD, the controlling resistance (i.e., rate-limiting step) of these three for small solutes is typically the blood compartment, although membrane resistance becomes controlling at relatively low MW ( Fig. 2 ) [9] . Each of these components will be discussed separately.…”

Section: Diffusive Solute Removalmentioning

confidence: 99%

“…3 ) [9] . For a given solute, in the relatively low Q B regime, an effectively linear relationship exists between these two parameters.…”

Section: Blood Compartmentmentioning

confidence: 99%

“…These principles are illustrated in Figure 7 [9] . When secondary membrane formation and concentration polarization are minimal (e.g., at low ultrafiltration rates), blood compartment solute concentrations are relatively homogeneous, and the reflection coefficient (σ) can be reliably determined as a function of the measured blood concentration.…”

Section: Convective Solute Removalmentioning

confidence: 99%

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Solute Transport in Hemodialysis: Advances and Limitations of Current Membrane Technology

Clark¹,

Gao²,

Neri³

et al. 2017

Contributions to Nephrology

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Extracorporeal therapy for end-stage renal disease is now provided to more than three million patients globally. Nearly all treatments are performed with filters containing hollow fiber membranes, removing solutes and water by diffusion, convection, and ultrafiltration. In this review, we will provide a detailed quantitative analysis of the transport processes involved in different hemodialysis (HD) therapies. We will also report some technical aspects of hollow fiber membranes and filters composed of them along with the mechanisms of solute and water removal for such devices. Diffusive mass transfer will be assessed according to the three major aspects of a hollow fiber filter (blood compartment, membrane, and dialysate compartment). With regard to convective transport, the importance of internal filtration as a solute removal mechanism in high-flux HD will be highlighted, along with the critical role that blood/membrane interactions assume in filtrationbased therapies.

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Section: Blood Compartmentmentioning

confidence: 97%

Section: Diffusive Solute Removalmentioning

confidence: 99%

“…3 ) [9] . For a given solute, in the relatively low Q B regime, an effectively linear relationship exists between these two parameters.…”

Section: Blood Compartmentmentioning

confidence: 99%

Section: Convective Solute Removalmentioning

confidence: 99%

See 2 more Smart Citations

Solute Transport in Hemodialysis: Advances and Limitations of Current Membrane Technology

Clark¹,

Gao²,

Neri³

et al. 2017

Contributions to Nephrology

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“…Renal failure is a condition in which the kidneys fail to remove metabolic end products from the blood. 2 In most cases, patients with renal failure need hemodialysis. In hemodialysis water and dissolved solutes move from blood to dialysate, and allows the removal of several liters of excess°uid during a typical 2 to 4 h treatment.…”

Section: Introductionmentioning

confidence: 99%

A new approach for detecting sudden hypotension in hemodialysis by using dual-channel optical system

Amin

Golmakani

Joharinia

2017

J. Innov. Opt. Health Sci.

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Dialysis hypotension is one of the most prevalence symptoms of dialysis and occurs in 40% of treatment sessions. Detection and prediction of hypotension is important for the well-being of the patient and for optimizing treatment. The aim of this study was to construct optical system to monitor blood pressure (BP) continuously and without cu® in hemodialysis based on pulse transit time (PTT) method. To measure the BP changes, dual-channel optical system were developed. In this study, individuals were classi¯ed into two groups of normal and hemodialysis. In both groups, BP and consequently PTT were earned three times in di®erent positions. After the initial calibration, the regression equation was drawn for each subject. In normal group, each subject was placed in the supine position and BP was measured both by designed system and sphygmomanometer cu®. During BP measurements, in addition to BP, blood pressure decline was also monitored by optical system. For hemodialysis group, the same measurement setup was adopted. In both groups, the error between cu® method and PTT was calculated. Correlation coe±cients for BP cuff vs BP PTT were calculated and Bland-Altman plot was performed for the normal and hemodialysis groups. In this study 16 subjects participated. The results for normal group showed that maximum di®erence between cu® method and the present method was 14 mmHg and for dialysis group was 16 mmHg. Bland-Altman plot in normal group revealed limits of agreement from À13.98 to 13.18 mmHg. Considering hemodialysis group, limits of agreement were from * Corresponding author. This is an Open Access article published by World Scienti¯c Publishing Company. It is distributed under the terms of the Creative Commons Attribution 4.0 (CC-BY) License. Further distribution of this work is permitted, provided the original work is properly cited. À15.94 to 13.88 mmHg. The correlation coe±cient was 0.74 for normal group and was 0.72 for hemodialysis group. The proposed system can monitor BP continuously and diagnose sudden hypotension. So it can be recommended as a useful method to indicate hypotension and can be used for dialysis unit.

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Recent Progress of Microfluidic Devices for Hemodialysis

Luo

Fan

Wang

2019

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Microfluidic hemodialysis techniques have recently attracted great attention in the treatment of kidney disease due to their advantages of portability and wearability as well as their great potential for replacing clinical hospital‐centered blood purification with continuous in‐home hemodialysis. This Review summarizes the recent progress in microfluidic devices for hemodialysis. First, the history of kidney‐inspired hemodialysis is introduced. Then, recent achievements in the preparation of microfluidic devices and hemodialysis nanoporous membrane materials are presented and categorized. Subsequently, attention is drawn to the recent progress of nanoporous membrane‐based microfluidic devices for hemodialysis. Finally, the challenges and opportunities of hemodialysis microfluidic devices in the future are also discussed. This Review is expected to provide a comprehensive guide for the design of hemodialysis microfluidic devices that are closely related to clinical applications.

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The haemodialysis system: basic mechanisms of water and solute transport in extracorporeal renal replacement therapies

Cited by 59 publications

References 0 publications

Solute Transport in Hemodialysis: Advances and Limitations of Current Membrane Technology

Solute Transport in Hemodialysis: Advances and Limitations of Current Membrane Technology

A new approach for detecting sudden hypotension in hemodialysis by using dual-channel optical system

Recent Progress of Microfluidic Devices for Hemodialysis

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