145 A New High Flux Polysulfone Dialyzer with Waved Fibers Possessing Larger Pores Packed in Lower Fiber Density (Aps-Ea) Is Superior in Eliminating Low Molecular-Weight Proteins as Well as Small Toxins in Comparison to a Conventional Polysulfone Dialyzer with Straight Fibers Possessing Conventional Pores in Popular Fiber Density (Aps-El)

Abstract

A NEW HIGH FLUX POLYSULFONE DIALYZER WITH WAVED FIBERS POSESSING LARGER PORES PACKED IN LOWER FIBER DENSITY (APS-EA) IS SUPERIOR IN ELIMINATING LOW MOLECULAR-WEIGHT PROTEINS AS WELL AS SMALL TOXINS IN COMPARISON TO A CONVENTIONAL POLYSULFONE DIALYZER WITH STRAIGHT FIBERS POSSESING CONVENTIONAL PORES IN POPULAR FIBER DENSITY (APS-EL) Emi Kihara, Miho Kando, Daisuke Okita, Nozomi Okada, Ken-ichi Taira, Yasuo Nomura, Kimiko Takahashi, Kazuko Arita, Katsutoshi Maeda, Hiroaki Oda, Oda Medical Clinic, Hiroshima, Japan. Advanced progress of a high flux polysulfone dialyzer has improved the prognosis of long-term hemodialysis (HD) patients in Japan. The purpose of this study is to elucidate beneficial effects of APS-EA compared to APS-EL in eliminating uremic toxins taking account of the differences in the shape of fibers (waved vs. straight), shape of baffles (extended vs. partial), average pore diameters (8.5 nm vs. 8.3 nm) and hallow fiber packed densities (58% vs. 71%). Elimination rates of low molecular-weight proteins (β2 microglobulin; β2-m and α1 microglobulin; α1-m) as well as small toxins (BUN, creatinine, uric acid) were estimated in 49 maintenance HD patients using APS-EL followed by APS-EA. Paired Student’s t-test was applied to the statistical analysis and p<0.05 was considered significant. Elimination rates are shown in the following table (mean±SD). β2-m α1-m BUN creatinine uric acid APS-EL 66.3±6.6 14.4±4.2 65.2±7.5 59.3±6.8 67.7±7.1 APS-EA 69.1±6.3 25.5±5.0 67.1±7.8 60.4±7.1 69.1±7.7 p value <0.01 <0.01 <0.01 <0.01 <0.01 APS-EA showed significantly higher elimination rates of low molecular-weight proteins and small toxins than APS-EL. An average value of Kt/V in APS-EA (1.35±0.30) was significantly higher than that in APS-EL (1.28±0.27), while serum albumin concentration in APS-EA (3.75 g/dl) showed slight decrease compared with that in APS-EL (3.87 g/dl). In conclusion, APS-EA, waved fibers with larger pores in less fiber packed density in an extended baffle, further developed the better performance of high flux polysulfone membrane.