抄録
An Innovative, simultaneous hemof filtration and hemodialysis system was developed which has absolutely no need of the infusion fluid. The system employs two high-flux membrane dialyzers in a direct series, and causes the dialysate to flow in the direction opposite the blood flow. First, a dialysate flow equalizer was employed to control the dialysate flow at the inlet and outlet, and their difference was arranged to be the water removal from the body. Moreover, when the blood circuit was clamped between the two dialyzers, the UF was performed at the 1st dialyzer: at the 2nd one, the dialysate moved to the blood side as a replacement fluid automatically, in terms of the rate of UF. In the clinical evaluation, the clearances of β2-microglobulin and RBP were 49.3ml/min and 29.2ml/min respectively, where those of the control β2-microglobulin and RBP were 8.2ml/min and 0ml/min, respectively. Since the dialysate serves as the replacement fluid in the new system, however, the pyrogen and bacteria problem must be solved. To remove them, tap water is subjected to coarse filter, activated charcoal, ion exchange and reverse osmosis treatment, followed by preparation of the dialysate. Clinically, there are no side effects, and the system is safe, effective and practical.
