A study of novel and optimal technology for hemodialysis

Overall goal of this project is to investigate and develop novel and optimal techniques/technology for hemodialysis, including three objectives: (1) Using advanced technology and developing novel methods to characterize and optimize artificial kidney performance; (2) Developing optimal/novel approaches to enhance the artificial kidney performance; (3) Developing optimal ceramic membrane for use in artificial kidney.; Scanning Electron Microscopy was used to reveal fine structure of four different dialysis membranes. The pores size and pore distribution of these membranes are irregular and non-uniform. The local clearances of small uremic solutes for the dialyzers were evaluated, and urea mass transfer-area coefficient (K_oA) was measured in the novel design experimental system. The fiber bundles are distributed non-uniformly within a dialyzer, contributing to varying local clearance. The urea K_oA changed with both dialysate (Q_d) and temperature. Increasing Q_d to 800 mL/min is one of optimal choice for certain patients to reach adequate targets. The effect of reprocessing on solute permeability of a polyethersulfone hemodialyzer was assessed by multiple reuse cycles. The pore size of the membrane was altered by reprocessing with Renalin® 100 after 10 times reuse, but the clearance reduction of small solutes did not reach clinical significance. The backtransfer of cytokine-induced substance was evaluated in a polyethersulfone dialyzer under very crucial conditions favoring CIS transfer. The result indicates that polyethersulfone membrane has the ability to exclude CIS by a combination of size exclusion and material adsorption. The effect of pre and post dilution of continuous hemofiltration and hemodiafiltration under several high ends of clinical conditions on clearance profiles for surrogate molecules were investigated. The no filtration fraction constrained pre dilution mode may make it the preferred mode for high volume hemofiltration and intermittent dialysis treatment. A dual cartridge dialysis system with internal filtration was developed. Results showed that it is one of optional or optimal treatment for the dialysis patients. Finally, a ceramic membrane was developed for potential use in hemodialysis. The optimal conditions for the formation of ordered structures of a ceramic membrane with pore size of ∼10 nm are 3% or 5% sulfuric acid with 125V to 17.5V at 0°C.