濾過型血液浄化器の溶質除去特性に関する研究

概要

論文の詳細を見る
On-line hemofiltration (HF) and hemodiafiltration (HDF) using purified dialysate as a substitution fluid have recently become a focus of major interest. The purpose of this study is to clarify the characteristics of solute removal, particularly the effects of blood flow rate (Q_B), filtration flow rate (Q_F) and dilution modality on solute clearance (CL) and apparent sieving coefficient (SC_1) under HF and HDF therapies with high ultra filtration. In order to clarify the characteristics of solute removal, we carried out an experimental study using an aqueous solution and a clinical study. Six significant conclusions were determined from the results. Myoglobin SC_1 value decreased with increasing Q_B under a constant Q_F value. This was due to a higher shear rate of blood flow that reduced the thickness of the concentration polarization layer. SC_1 is one of the apparent sieving coefficients and is defined as the filtrate concentration divided by the inlet concentration. The SC_1 value also decreased with increasing QF in the low filtration fraction (FF) due to the development of concentration polarization. However, the SC_1 value increased with Q_F in higher FF filtration because of stronger solute condensation along the blood stream. Post-dilution HF had a larger CL value than pre-dilution HF under the same Q_F value. The setting of the Vs value in post-dilution HF, however, strongly depends on a patient's Q_B value but it can be theoretically increased infinitely for predilution HF. From an estimation using a material balance equation, pre-dilution HF with an approximate replacement of 34 L has the same CL value as post-dilution HF with a 20 L replacement. In post-dilution HDF, the CL value increased with Q_F particularly in larger molecular weight substances. However, in predilution HDF, the CL value increased with Q_F in larger molecular solutes, was almost unchanged in middle molecular solutes and decreased slightly in smaller molecular solutes. An interaction between diffusive and convective transport is an important factor in HDF. Specifically convection is more effective in lower diffusive solutes, and less effective in higher diffusive solutes in HDF.
東京女子医科大学の論文
1996-05-25

濾過型血液浄化器の溶質除去特性に関する研究

スポンサーリンク

概要

著者

関連論文

スポンサーリンク