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Pulse Push/Pull Hemodialysis: In Vitro Study on New Dialysis Modality With Higher Convective Efficiency
Author(s) -
Lee Kyungsoo,
Lee Sa Ram,
Mun Cho Hae,
Min Byoung Goo
Publication year - 2008
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.1525-1594.2008.00561.x
Subject(s) - pulsatile flow , ultrafiltration (renal) , hemodialysis , albumin , dialysis , chemistry , creatinine , inulin , blood flow , chromatography , blood urea nitrogen , urology , medicine , surgery , biochemistry
Midsize molecule retention is related with renal‐failure‐associated mortality. Here, the authors describe a new dialysis modality, pulse push/pull hemodialysis (PPPHD), which increases convective clearance. Blood and dialysate are circulated by a pulsatile pump, but with pulsatile flow patterns that are 180° out of phase. This causes blood‐to‐dialysate pressure gradients that oscillate between positive and negative, and which cause consecutive periods of ultrafiltration and backfiltration. The devised PPPHD was compared with conventional high‐flux hemodialysis (CHFHD) in terms of solute clearances, albumin loss, and total protein levels. Human plasma containing dissolved uremic marker molecules was used as a blood substitute, and clearances were investigated for blood urea nitrogen, creatinine, vitamin B12, and inulin. Observed clearances were found to be significantly higher for PPPHD by approximately 3–14% for low‐molecular‐weight solutes, by 47–48% for vitamin B12, and by 38–49% for inulin than for CHFHD. No albumin loss was observed in either of these two study groups. The authors conclude that PPPHD offers a simple straightforward means of enhancing uremic molecule removal by increasing total ultrafiltration volume without the need to infuse replacement fluid.