See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/330688874 A Brief Presentation of the Characteristics of Hemodialysis Membranes Article in MATERIALE PLASTICE · September 2018 DOI: 10.37358/MP.18.3.5023 CITATIONS READS 3 63 6 authors , including: Laura R ă ducu Balan Daniela Gabriela Clinical Emergency Hospital "Prof.Dr.Agrippa Ionescu"Bucharest,Romania Carol Davila University of Medicine and Pharmacy 54 PUBLICATIONS 86 CITATIONS 56 PUBLICATIONS 74 CITATIONS SEE PROFILE SEE PROFILE Dorin Ionescu Balcangiu-Stroescu Andra-Elena UMF Carol Davila Bcuuresti Spitalul Universitar de Urgen ţă Bucure ş ti 36 PUBLICATIONS 49 CITATIONS 41 PUBLICATIONS 79 CITATIONS SEE PROFILE SEE PROFILE Some of the authors of this publication are also working on these related projects: Cardiovascular disease View project Chronic Kidney Disease View project All content following this page was uploaded by Balcangiu-Stroescu Andra-Elena on 28 January 2019. The user has requested enhancement of the downloaded file.
A Brief Presentation of the Characteristics of Hemodialysis Membranes ANDRA ELENA BALCANGIU STROESCU 1,2 *, MARIA DANIELA TANASESCU 3,4 , ALEXANDRU DIACONESCU 2 , LAURA RADUCU 5,6 , DANIELA GABRIELA BALAN 1 , DORIN IONESCU 3,7 1 Carol Davila University of Medicine and Pharmacy Discipline of Physiology, Faculty of Dental Medicine, 8 Eroii Sanitari, 050474, Bucharest, Romania 2 Emergency University Hospital, Department of Dialysis, 169 Splaiul Independenei, 050098, Bucharest, Romania 3 Carol Davila University of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Semiology, Discipline of Internal Medicine I and Nephrology , 8 Eroii Sanitari, 050474, Bucharest, Romania 4. Emergency University Hospital, Department of Nephrology,169 Splaiul Independenei, 050098, Bucharest, Romania 5 Carol Davila University of Medicine and Pharmacy, Faculty of Medicine, Department of Plastic and Reconstructive Microsurgery, 8 Eroii Sanitari, 050474, Bucharest, Romania 6 Prof. Dr. Agrippa Ionescu Clinical Emergency Hospital, Department of Plastic and Reconstructive Surgery, 7 Ion Mincu, 011356, Bucharest, Romania 7 Emergency University Hospital, 169 Splaiul Independenei, 050098, Bucharest, Romania The survival of CKD patients has known significant improvement with the appearance of extrarenal clearance methods. Being a domain in a rapid progression, the hemodialysis membranes have been, in time, one of the key modifying points. In this paper will make a short presentation of the features of hemodialysis membranes and will point out aspects which need future research. Keywords:hemodialysis, hemodialysis membranes, cellulose, polymers, inflammation such as albumin, and have a higher chronic hemodialysis In 1943 the dutch physicist Willem Kolff revolutionized session efficiency. (greater URR, Kt/V values compared to Nephrology by building the first hemodialysis machine. The low flux membranes) [4,6]. research this build was based on was an article belonging The main toxin clearing mechanism is through diffusion to the Johns Hopkins University. It contained principles of and it is achieved by any hemodialysis membrane. Through toxin clearance in animals. A next big step in the history of this mechanism the solutes travel from one compartment hem odialysis was the invention of a vascular access to another, based on the concentration gradient of the two pathway for patients who required long term extrarenal compartments [7]. clearance[1]. Because the survival of patients with Through convection, achieved by high flux dialysis irreversibly affected renal function requires m ultiple machines, the low molecular mass proteins and the solutes hem odialysis sessions, the research in this field was are separated from the formed elements, limiting their loss. focused on building devices which were well tolerated by This process relies on porosity and the increase of the the human body and with good toxin clearance [2]. efficiency of molecule transfers [3,8]. Adsorption is the third mechanism through which the Experimental part clearing of uremic toxins from the organism is made In patients with severely altered renal function, usage possible . It re lie s on the pore s’ structure and the of different types of hemodialysis membranes ensures the hydrophobicity of the membrane [3,9]. removal of toxins from the organism. These devices allow Hem odialysis m em branes were initially built from the extrarenal clearing of the blood based on the physical cellophane, later from cellulose and nowadays from phenomena of diffusion, convection and absorption[2]. synthetic materials(synthetic polymers) which have made The molecules which are removed from the organism significant progress in solute clearing capacity[10]. are classified by molecular mass as small molecules (mass Hem odialysis m em branes m ade from cellulose have below 500 Da); medium sized molecules (mass ranging athicknessranging from 6.5-15 µ m, being classified as thin from 500-15000 Da) and large molecules (mass greater hemodialysis membranes. To ensure solute diffusion, they than 15000 Da). Regarding clearance capacity, sm all have a uniform, symmetric fiber structure. Unlike them, m olecules are filtered through diffusion, while large the synthetic membranes have a thickness> /= 20 µ m and m olecules require large-pore m em branes (high flux their structure can be symmetric or asymmetric. Typical m e m brane s). High flux m e m brane s also have the for the asymmetric membranes is that they are fabricated advantage of limiting large molecular mass protein loss, T able 2 TYPES OF SOLUTES BY MOLECULAR M A SS * email: stroescu_andra@yahoo.ro MATERIALE PLASTICE ♦ 55 ♦ No. 3 ♦ 2018 332 http://www.revmaterialeplastice.ro
from synthetic polymers and its fibers are curled up [2] to polym ethacrylate (PMMA), vinyl alcohol-co-ethylene facilitate a wider contact surface between it and the (EV AL), and polyacrylonitrile (PAN) [3]. patient’s blood. From specialized literature we have Using synthetic membranes plays an important part in concluded that some synthetic membranes consist of a assuring increased biocompatibility, so that there are thin inner layer which is surrounded by a thick outer layer m inim al rejection reactions from the organism . This with supportive role, while other hemodialysis membranes suggests the fact that biocompatible membranes lead to consist of 3 types of layers, of which the outer one has a a decreased inflammatory response from the body, which, supportive role [3]. when it appears due to low biocompatibility membrane usage , le ads to e ithe r he m odynam ic instability or am yloidosis. Also, high biocom patibility m em branes Results and discussions Diffe re nt m ate rials are use d in the he m odialysis decrease the m orbidity and m ortality of chronically membrane fabrication process, such as polysulfone(PSF), hemodialyzed patients [11]. polyethilenesulfone(PES), cellulose triacetate (CTA), T able 1 CHARACTERISTICS OF SYNTHETIC HEMODIALY SIS MEMBRANES MATERIALE PLASTICE ♦ 55 ♦ No. 3 ♦ 2018 http://www.revmaterialeplastice.ro 333
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