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Present Status of the Hemofiltration/Molecular Separation Artificial Kidney
Author(s) -
Dorson William J.,
Pizziconi Vincent B.
Publication year - 1979
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/j.1525-1594.1979.tb03795.x
Subject(s) - ultrafiltration (renal) , artificial kidney , hemofiltration , membrane , dialysis , chemistry , hemodialysis , chromatography , biomedical engineering , thermal diffusivity , materials science , biophysics , surgery , medicine , biochemistry , thermodynamics , biology , physics
ABSTRACT The hemofiltration/molecular separation (HFMS) artificial kidney concept, first proposed over a decade ago, involves continuous ultrafiltration from the blood stream followed by cleansing of the filtrate, with subsequent return to the body. Thus, the system is completely self‐contained and portable. During recent preclinical trials on nephrectomized canines, HFMS was better than hemodialysis (HD) in several important ways. First, the removal or clearance of middle molecules was better with 0.34 m 2 HFMS than with 1 m 2 HD. Significant phosphate clearance was achieved, and the removal rate for creatinine was the same as that for urea. This uniform clearance extends to even higher molecular weight solutes and could potentially result in improved patient response. It mimics the real kidney, whereas membrane‐limited dialysis undergoes a logarithmic decrease of clearance with molecular weight., This is due to the fact that solute transport through the membrane involves solution into its matrix followed by diffusion, and solute diffusivity decreases with molecular volume. In order to achieve this potential for hemofiltration‐based systems, however, there are stringent requirements on both the membrane and the plasma proteins allowed to accumulate on the membrane surface.