Abstract
Dialysis membranes were traditionally classified according to their material compositions (i.e., as cellulosic or synthetic) and on the basis of the new concept of the sieving coefficient (determined by the molecular weight retention onset and molecular weight cut-off). The advantages of synthetic polymer membranes over cellulose membranes are also described on the basis of their physical, chemical, and structural properties. Innovations of dialysis membrane in recent years include the development of medium cutoff membranes; graphene oxide membranes; mixed-matrix membranes; bioartificial kidneys; and membranes modified with vitamin E, lipoic acid, and neutrophil elastase inhibitors. The current state of research on these membranes, their effects on clinical outcomes, the advantages and disadvantages of their use, and their potential for clinical use are outlined and described.
Highlights
Introduction and the History of DialysisMembranesHemodialysis is an extracorporeal blood-cleansing technique used to remove uremic toxins that accumulate in patients with end-stage renal disease (ESRD)
Hemodialysis consists of the following steps: A patient is connected to a dialysis machine and their blood is pumped out via vascular access and filtered using a dialyzer
The main improvement achieved with the shift from high cutoff (HCO, characterized by a substantial increase in water permeability relative to both the high flux and a virgin β2m sieving coefficient (SC) of 1.0) to medium cutoff (MCO) membrane technology was the narrowing of the pore size distribution range
Summary
Hemodialysis is an extracorporeal blood-cleansing technique used to remove uremic toxins that accumulate in patients with end-stage renal disease (ESRD). A rotating drum kidney was the first membrane configuration used to treat large numbers of patients on hemodialysis (HD) [2] This device had a 30 m long cellophane tube with an inner diameter of 35 mm that was wrapped in a spiral manner around a cylinder that rotated in a stationary dialysate bath. Of Diffusive transfer efficiency improved with thisa cylinder that in a stationary dialysate bath.with It lacked a blood pumpsuch and as could device due to rotated the narrowness of the blood channels material innovation the generate only low transmembrane pressures,which affected thedevices ultrafiltration rate.comThe use of a new thin-walled cellulosic membrane. Blood pressures could be ratio achieved this device due and reducing boundary layer effects with acceptable pressure drops. was to the narrowness of the blood channels, but high end-to-end compartmental resistance generated
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