透析器东丽 NV-U® Hydrolink™ 对介质分子的去污能力:用于进行在线血液渗滤的新型亲水膜。

IF 1.4 4区 医学 Q4 ENGINEERING, BIOMEDICAL
Maria Kislikova, Almudena Vega, Eduardo Verde, Soraya Abad, Marco Vaca, Adriana Acosta, Angela González, Arturo Bascuñana, Antonia Mijailova, Coraima Nava, Miguel Villa, Juan Carlos Ruiz, Marian Goicoechea
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引用次数: 0

摘要

简介:目前正在开发具有新特性的新型透析膜,以提高疗效和耐受性。高分子生物材料的血液相容性受血膜界面水层的影响。新型透析器 TORAY NV-U® 的膜 Hydrolink™ 可抑制血小板粘附并改善血液相容性。到目前为止,还没有在线血液透析滤过(OL-HDF)方面的经验。本研究的目的是评估这种新型膜与另一种常用膜相比在 OL-HDF 治疗中的疗效。其他目的还包括评估炎症反应、血液动力学耐受性和抗凝方案:这是一项前瞻性试验研究,在五名接受 OL-HDF 治疗的无尿患者中进行。在一个月的时间里,患者一直使用他们常用的透析器 FX1000®(FMC)。随后,透析器改为 TORAY NV-U® (Hydrolink®),为期 1 个月。在每种透析器的最后一次透析过程中,都进行了血液检测,以评估炎症和去污能力:结果:我们没有发现中型清除分子和对流容量方面的差异:FX100031±9升/次和Hydrolink™ 30±8升/次;p = 0.7);β2微球蛋白还原率(RR)FX1000® FMC 83±3%;Hydrolink™ 79±4;p = 0.14;肌红蛋白还原率FX1000® FMC 72±7%;Hydrolink™ 76±4;p = 0.28。我们没有发现炎症参数的差异:血清 IL6 FX1000® 6.0 ± 4.2 pg/mL;Hydrolink™ 7.6 ± 5.0 pg/mL;p = 0.3。所有患者在使用 TORAY NV-U® 的所有透析过程中,透析器状态均为 "良好",而使用 FX1000® 的透析过程中,20% 的透析器状态为 "良好",30% 的透析器状态为 "中等",其余 50% 的透析器状态为 "不佳":结论:新型透析器Hydrolink™、TORAY NV-U®在进行OL-HDF透析时的效果并不比通常用于该疗法的透析器差,而且可以减少肝素剂量。样本量更大、随访时间更长的进一步研究将回答 Hydrolink 是否能改善炎症并评估更好的血液动力学耐受性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Depurative capacity toward medium molecules of the dialyzer Toray NV-U® Hydrolink™: A new hydrophilic membrane to perform online hemodiafiltration.

Introduction: New dialysis membranes with new properties are being developed to improve efficacy and tolerance. The hemocompatibility of a polymeric biomaterial is influenced by the layer of water at the blood membrane interface. The new dialyzer TORAY NV-U® has a membrane Hydrolink™, designed to suppress platelet adhesion and to improve the hemocompatibility. Until now, there is no experience in online hemodiafiltration (OL-HDF).The objective of the present study is to evaluate the efficacy of this new membrane in OL-HDF therapy compared to another membrane commonly used. Other objectives are to evaluate the inflammatory response, hemodynamic tolerance, and the anticoagulation regimes.

Methods: This is a prospective pilot study performed in five anuric patients receiving OL-HDF. For 1 month patients were kept with their usual dialyzer FX1000® (FMC). Subsequently, the dialyzer was changed to TORAY NV-U® (Hydrolink®) for 1 month. In the last dialysis session of each dialyzer, blood tests were performed to evaluate inflammation and depurative capacity.

Results: We did not find differences in medium size removal molecules and convective volume: FX1000®: 31 ± 9 l per session and Hydrolink™ 30 ± 8 l; p = 0.7); β2microglobulin reduction ratio (RR) FX1000® FMC 83 ± 3%; Hydrolink™ 79 ± 4; p = 0.14; Myoglobin RR FX1000® FMC 72 ± 7%; Hydrolink™ 76 ± 4; p = 0.28. We did not find differences in inflammation parameters: serum IL6 with FX1000® 6.0 ± 4.2 pg/mL; Hydrolink™ 7.6 ± 5.0 pg/mL; p = 0.3.During all sessions with the two dialyzers there was adequate plasmatic filling, reaching 85 % filling. All patients had "good" dialyzer status in all dialysis sessions with TORAY NV-U®, while the dialyzer status with FX1000® was "good" in 20% of the sessions, "medium" in 30%, and "dirty" in the remaining 50% dialysis sessions.

Conclusions: The new dialyzer Hydrolink™, TORAY NV-U® is not inferior to perform OL-HDF compared to dialyzers usually used for this therapy, and could allow decrease heparin doses. Further studies with a bigger sample size and longer follow-up will answer if Hydrolink improves inflammation and assess a better hemodynamic tolerance.

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来源期刊
International Journal of Artificial Organs
International Journal of Artificial Organs 医学-工程:生物医学
CiteScore
3.40
自引率
5.90%
发文量
92
审稿时长
3 months
期刊介绍: The International Journal of Artificial Organs (IJAO) publishes peer-reviewed research and clinical, experimental and theoretical, contributions to the field of artificial, bioartificial and tissue-engineered organs. The mission of the IJAO is to foster the development and optimization of artificial, bioartificial and tissue-engineered organs, for implantation or use in procedures, to treat functional deficits of all human tissues and organs.
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