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Nephrol Dial Transplant (2004) 19: 293-296
© ERA–EDTA 2004; all rights reserved

Editorial Comments

Which dialyser membrane to choose?

Tony Bouré and Raymond Vanholder

University Hospital Ghent, Department of Internal Medicine, Nephrology Division, Ghent, Belgium

Correspondence and offprint requests to: Raymond Vanholder, University Hospital Ghent, Department of Internal Medicine, Nephrology Division, De Pintelaan 185, B-9000 Ghent, Belgium. Email: raymond.vanholder@ugent.be

Keywords: bioincompatible; cellulose; dialyser; high-flux; low-flux; synthetic

The first 10% of the full text of this article appears below.

Introduction

Exchanges through dialyser membranes aim: (i) at the removal of uraemic solutes that are retained because of renal failure (e.g. urea) and (ii) at the restoration of depleted compounds (e.g. bicarbonate).

The originally used cellulosic membranes were derived from cotton and therefore named ‘natural’. They activated complement and leukocytes, inducing an inflammatory reaction as one of the indices of ‘bioincompatibility’ [1]. Later on, chemically developed ‘synthetic’ polymers appeared to mitigate this activation [2]. Furthermore, masking hydroxyl groups, which are responsible for the complement activation with cellulosic membranes, also resulted in more biocompatibility [3]. Therefore, cuprophan and its analogues were called ‘unmodified cellulosic’ vs the more biocompatible, later developed ‘modified/regenerated cellulosic’ membranes.

Many synthetic membranes have large pore sizes allowing higher rates of water flux and permitting a higher ultrafiltration . . . [Full Text of this Article]

Relevant membrane characteristics

Biocompatibility towards leukocytes and the complement system
Impermeability against dialysate impurities
Adsorption
Pore size
Summary
Clinical consequences

Conclusion


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