Abstract
Hemofilters for continuous hemodiafiltration (CHDF) have been expected not only long lifetime but also high clearance capacity of low molecular proteins, which may cause multiple organ dysfunction syndrome (MODS). To evaluate commercially available hemofilters for CHDF, 18 critically ill patients with renal failure were randomly assigned to receive one of five commercial hemofilters; Panflo APF-06S (APF, Asahikasei Medical), PS filter C07 (PS, Kuraray Medical), Hemofeel CH-0.6L (Toray Medical), UT filter UT-700S (Nipro), and Hemofeel SH-0.8 (SH, Toray Medical); whose membranes were made of polyacrylonitrile, polysulfone, polymethyl methacrylate, cellulose triacetate, and polysulfone, respectively. Solute clearance and sequential ultrafiltration rate were determined. Clearances of small solutes (urea and creatinine) were not significantly different among these hemofilters and did not decrease throughout 24 hours. Clearances of low molecular proteins (β2 microglobulin, myoglobin, and interleukin-6) by APF and PS were higher than the others, and scarcely decreased even at 24 hours after. All filters were insufficient to remove α1 microglobulin, molecular weight of 33 kDa, and no filters leaked albumin. Both APF and SH showed higher ultrafiltration rates and longer lifetime over 24 hours than the others. These results suggest that APF may be the best hemofilter for CHDF in the treatment of critically ill patients with renal failure.
