Abstract
The patients with end stage kidney disease need haemodialysis therapies, using an artificial kidney. Nevertheless, the current therapies cannot remove a broad range of uremic toxins compared to the natural kidney. Adsorption therapies, using sorbent-based columns, can improve the clearance of uremic toxins, but the sorbent particles often require polymeric coatings to improve their haemocompatibility leading to mass transfer limitations and to lowering of their performance.Earlier, we have developed a dual layer Mixed Matrix fiber Membrane (MMM) based on polyethersulfone/polyvinylpyrrolidone (PES/PVP) polymer blends. There, the sorbent activated carbon particles are embedded in the outer membrane layer for achieving higher removal whereas the inner blood contacting selective membrane layer should achieve optimal blood compatibility. In this work, we evaluate in detail the haemocompatibility of the MMM following the norm ISO 10993–4. We study two generations of MMM having different dimensions and transport characteristics; one with low flux and no albumin leakage and another with high flux but some albumin leakage. The results are compared to those of home-made PES/PVP single layer hollow fiber and to various control fibers already applied in the clinic. Our results show that the low flux MMM successfully avoids contact of blood with the activated carbon and has good haemocompatibility, comparable to membranes currently used in the clinic. Statement of SignificanceHaemodialysis is a life-sustaining extracorporeal treatment for renal disease, however a broad range of uremic toxins cannot still be removed. In our previous works we showed that a double layer Mixed Matrix Membrane (MMM) composed of polyethersulfone/polyvinylpyrrolidone and activated carbon can achieve higher removal of uremic toxics compared to commercial haemodialysers. In this work we evaluate the haemocompatibility profile of the MMM in order to facilitate its clinical implementation. The lumen particle-free layer of the MMM successfully avoids the contact of blood with the poorly blood-compatible activated carbon. Moreover, thanks to the high amount of polyvinylpyrrolidone and to the smoothness of the lumen layer, the MMM has very good haemocompatibility, comparable to membranes currently used in the clinic.
Highlights
A prominent loss of kidney function occurs in end-stage kidney disease (ESKD) patients
It is important to highlight that in our previous work [31] we have shown that the water permeability of the LF-Matrix Membrane (MMM) can be improved by washing the membrane with pure ethanol, still maintaining retention properties of the selective layer against plasma proteins
We studied the haemocompatibility profile of two Mixed Matrix Membranes (MMM), one with low flux properties and no albumin leakage (LF-MMM) and another characterized by high flux and albumin leakage (HF-MMM)
Summary
A prominent loss of kidney function occurs in end-stage kidney disease (ESKD) patients. A semi-permeable hollow fiber membrane is used for the transfer of uremic solutes from the blood compartment to the dialysis fluid compartment of the dialyser. There, the blood can be purified by passing through a column filled with porous sorbent particles [9,10,11]. HP is not designed to correct the fluid balance and the use of small size adsorbent particles may result in high pressure drop across the column which could lead to protein denaturation and/or blood cells damage. Unless additional filtration is applied, small fragments of the sorbent particles can be leached out of the column and end up in the patient’s blood stream [12,13]
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