In vivo Assessment of a Manual Single Lumen Alternating Micro-Batch Hemodiafiltration System

Abstract

Introduction: The manual single lumen alternating micro-batch hemodiafiltration (mSLAMB) system is a closed-loop dialysis system designed to provide kidney support in emergency situations (e.g., fluid overload, hyperkalemia, acidemia). If done repeatedly in small batches and at high flow rates, this system was found to achieve clearance levels comparable to traditional renal replacement therapy. Methods: Using a porcine model, uremic toxins and exogenous fluorescent tracer concentrations were successfully lowered within just 1 h of treatment. Results: With a maximal dialysate flow, mSLAMB can achieve decreases in serum potassium concentration of >0.5 mmol/L/h. With the mSLAMB hemodiafiltration system, micro-batch processing was also successful in removing up to 250 mL of ultrafiltrate in 8 cycles. Conclusion: This process could create a better fluid balance allowing for administering therapeutic fluids such as sodium bicarbonate in the clinic. Electrolyte imbalance and volume overload remain severe life-threatening emergencies in low resource settings; therefore, mSLAMB should be explored further due to its modest vascular access requirements, low cost, and ability to be performed without electricity or batteries.