Enhancement of Solute Removal in a Hollow-Fiber Hemodialyzer by Mechanical Vibration

被引:15
作者
Kim, Jeong Chul [1 ,2 ,3 ]
Garzotto, Francesco [1 ,2 ]
Cruz, Dinna N. [1 ,2 ]
Goh, Ching Yan [1 ,2 ,7 ]
Nalesso, Federico [1 ,2 ]
Kim, Ji Hyun [4 ]
Kang, Eungtaek [5 ]
Kim, Hee Chan [3 ,6 ]
Ronco, Claudio [1 ,2 ]
机构
[1] San Bortolo Hosp, Dept Nephrol, IT-36100 Vicenza, Italy
[2] Int Renal Res Inst Vicenza, Vicenza, Italy
[3] Seoul Natl Univ, Med Res Ctr, Inst Med & Biol Engn, Seoul, South Korea
[4] Seoul Natl Univ, Interdisciplinary Program Bioengn Major, Seoul, South Korea
[5] Chung Ang Univ Hosp, Dept Internal Med, Seoul, South Korea
[6] Seoul Natl Univ, Coll Med, Dept Biomed Engn, Seoul, South Korea
[7] Selayang Hosp, Dept Nephrol, Selangor, Malaysia
关键词
Hemofiltration; Hemodiafiltration; Vibration; Mechanical stress; Concentration polarization; Membrane fouling; Diffusion; Convection; Adsorption; MOLECULAR-WEIGHT PROTEINS; CONCENTRATION POLARIZATION; MEMBRANE INTERACTIONS; DIALYSIS MEMBRANE; FILTRATION; ADSORPTION; BLOOD; FLOW; HEMOFILTRATION; PERFORMANCE;
D O I
10.1159/000321073
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Better solute clearance, particularly of middle-molecular-weight solutes, has been associated with improved patient outcomes. However, blood-membrane interaction during dialysis results in the development of secondary mass transfer resistances on the dialyzer membrane surface. We discuss the potential effects of mechanical vibration on the diffusion, convection and adsorption of uremic solutes during dialysis. For sinusoidal and triangular vibratory motions, we conceptualized the hemodynamic changes inside the membrane and consequent effects on membrane morphology. Longitudinal vibration generates reverse flow by relative membrane motion, and transverse vibration generates a symmetric swirling flow inside the hollow fiber, which enhances wall shear stress and flow mixing. Moreover, the impulse induced by triangle wave vibration could provide higher absorption capacity to middle-molecular-weight solutes. Mechanical vibration could enhance solute removal by minimizing membrane morphology changes resulting from blood-membrane interaction during hemodialysis. These effects of mechanical vibration can be helpful in extracorporeal blood purification therapies including continuous, portable and wearable systems. Copyright (C) 2011 S. Karger AG, Basel
引用
收藏
页码:227 / 234
页数:8
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