关键词: 血液透析, 高通量透析器, 聚砜膜, 三醋酸纤维素膜, 清除有效性, 生物相容性

Abstract: ackground  High-flux hemodialysis has been widely used and has the advantages of improved clearance of uremic toxins and efficient removal of extra body fluid due to the hollow fiber membranes with a high ultrafiltration coefficient.  Objective   The present paper aims to investigate the clinical performance of two high-flux dialyzers, one equipped with polysulfone membranes (HF15 from Weigo), and the other equipped with cellulose triacetate membranes (FB-150U, short for 150U, from Nipro). Clearance efficiency of uremic toxins and the biocompatibility in a single hemodialysis session were compared between the two types of high-flux dialyzers.  Methods   A total of 20 patients treated with maintenance hemodialysis for more than 3 months were recruited from Weigao Blood Purification Center and were divided into two groups, HF15 Group (n=10) and 150U Group (n=10). Blood samples were collected right before the dialysis treatment, 15min and 60min during the treatment, and right after the treatment. The reduction ratio and clearance rate of uremic toxins as well as changes of blood cells and complement factor (C3a) were compared between the two groups.  Results   Age, sex, body weight and dialysis age were similar between two groups. Before the dialysis session, baseline parameters including treatment blood flow, small and medium molecule toxins, blood cells and complement factors had no significant differences between the two groups (P≥0.05). After the high-flux hemodialysis treatment for 4 hours, the reduction ratios and clearance rates of small molecule toxins (blood urea nitrogen, creatinine and phosphorus) had no significant differences between the two groups (For reduction ratios: t=0.932, 1.799 and 0.878 respectively; P=0.379, 0.052 and 0.299 respectively. For clearance rates: t=-1.892, 1.500 and -2.211 respectively; P=0.091, 0.168 and 0.056 respectively); HF15 group had higher reduction ratio (t=7.821, P＜0.001) and clearance rate (t=2.686, P=0.013) of the middle molecular toxin β2 microglobulin than 150U group. Variations of blood cells and C3a during the hemodialysis session had no statistical significances between two groups.  Conclusions   During a single high-flux hemodialysis session, HF15 group had higher clearance rates of uremic toxins than 150U group, with equal biocompatibility between the two groups.

Key words: Hemodialysis, High-flux dialyzer, Polysulfone, Cellulose triacetate, Clearance efficiency, Biocompatibility