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The role of dialyzer membrane flux in bio‐incompatibility
Author(s) -
DAVENPORT Andrew
Publication year - 2008
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/j.1542-4758.2008.00321.x
Subject(s) - membrane , medicine , flux (metallurgy) , hemodialysis , intensive care medicine , urology , chromatography , chemistry , materials science , biochemistry , metallurgy
Dialyzer membrane flux is currently defined according to β 2 ‐microglobulin (a middle molecule) clearance. Traditionally, high flux membranes were synthetic, and caused less inflammatory reaction in the extracorporeal circuit, compared with standard low‐flux cuprophan bio‐incompatible dialyzers. Initial reports suggested improved patient outcomes in acute renal failure when noncuprophan dialyzer membranes were used. However, over time these positive observations have not been substantiated. As the price differential between these dialyzer membrane types has become marginal, more high‐flux dialyzers are now used in routine clinical practice. Two multicenter trials have recently reported a survival advantage for high‐flux dialyzers. Whether this is directly consequent upon the choice of dialyzer membrane, or related to improvements in dialysate water quality, or changes in other clinical practices remains to be determined.