ハイパフォーマンスメンブレンの最近の進歩
1992 年 17 巻 1 号 p. 2-11
詳細
1992 年 17 巻 1 号 p. 2-11
More than 10 years of clinical experiences with conventional Cuprophane (CUP) were followed by the newly developed synthetic membranes such as Polyacrylonitrile (PAN), Polymethylmethacrylate (PM MA), and Ethylene Vinylalcohole (EVAL). These high flux new membranes were highly permeable to the middle molecule substances (500-5, 000 dalton).
Although, in 1985, the dialysis-related amyloidosis was discovered at the calpal tunnel syndrome lesions, which was analyzed and determined as a new type amyloidosis derived from beta-2-microglobulin (B2-MG) in the patients' plasma. B2-MG is a small molecular protein of 11, 800 dalton, and it is totally impossible to be removed from the plasma through CUP. The early high flux membranes also could not remove it sufficiently.
And then, the further new membranes, more permeable to B2-MG, have been developed recently which are called as high performance membranes (HPMs).
These HPMs have 0.2-0.7 of sieving coefficient values, or specific absorption properties to B2-MG. They showed 10-50% of the removal rates of B2-MG in the plasma even in hemodialysis procedure. But their longterm clinical benefits on the dialysis amyloidosis were not fully evaluated. Continuous therapy using HPMs from the beginning of blood purification strategy remains to be examined in future.
