Understanding membranes and dialysers:
The dialyser and its centrepiece, the membrane, play a central role in chronic renal replacement therapy. More than 1000 different types of dialysers are currently available on the market. How are these characterised and how do they differ? What are their special features and how do they contribute...
Saved in:
| Format: | Book |
|---|---|
| Language: | English |
| Published: |
Lengerich [u.a.]
Pabst
2004
|
| Series: | Good dialysis practice
5 |
| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Summary: | The dialyser and its centrepiece, the membrane, play a central role in chronic renal replacement therapy. More than 1000 different types of dialysers are currently available on the market. How are these characterised and how do they differ? What are their special features and how do they contribute to acute and chronic effects in the patient? Is there a link between morbidity and mortality and the use of a particular type of dialyser? This book addresses these questions and attempts answers based on current scientific knowledge. In this context, dialyser development and the basics of filter performance and biocompatibility assessment are reviewed. |
| Item Description: | Literaturangaben |
| Physical Description: | 616 S. Ill., graph. Darst. 21 cm |
| ISBN: | 3899670051 159326058X |
Staff View
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Record in the Search Index
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| adam_text | Table of contents
Section A.
Dialyser components and aspects of dialyser construction
1. Historical overview 15
2. Membrane family overview and nomenclature 36
2.1 Cellulose-based membranes 39
2.1.1 Regenerated cellulose 39
2.1.2 Modified regenerated cellulose (Hemophan® SMC8) 42
2.1.3 Regenerated cellulose grafts (AM-BIO, Excebrane) 45
2.1.4 Cellulose acetate 47
2.2 Synthetic membranes 50
2.2.1 Polyacrylonitrile (PAN, AN69®, AN69 ST) 51
2.2.2 Polymethylmethacrylate (PMMA) 54
2.2.3 Ethylenevinylalcohol copolymer (EVAL®) 56
2.2.4 Polycarbonate polyether (Gambrane®) 57
2.2.5 Polyamide 58
2.2.6 Polysulfones (Fresenius Polysulfone®, Helixone®,
a polysulfone, Asahi polysulfone®, Toraysulfone18) 59
2.2.7 Poly(aryl)ethersulfones
(PEPA®, Arylane, DIAPES®, Polyamix™) 63
3. Dialyser constructions 73
3.1. Parallel-plate dialysers 73
3.2 Hollow-fibre dialysers 75
4. Dialyser sterilisation 80
4.1 Sterilisation with ethylene oxide gas 83
4.2 Radiation sterilisation 86
7
4.3 Thermal sterilisation 91
4.4 Comparison of sterilisation procedures 93
Section B.
Dialyser performance
5. Performance parameters 103
5.1 Ultrafiltration coefficients 105
5.1.1 Standard values 107
5.1.2 Ultrafiltration coefficients in vivo 111
5.1.3 Association between ultrafiltration coefficient and
solute removal 113
5.1.4 The role of the ultrafiltration coefficient in backfiltration 115
5.2 Clearance, dialysance and KoA 117
5.2.1 Typical dialyser clearance values 120
5.2.2 Dialyser clearance in vivo 127
5.2.3 Effect of flow conditions on dialyser clearance -
the KOA concept 133
5.3 Specific measures for the removal of middle molecules 141
5.3.1 Membrane sieving coefficient 142
5.3.2 Percentage reduction during dialysis 146
5.3.3 Total amount of solute removed 148
5.3.4 Critical assessment of measures for middle
molecule removal 150
5.4 Retention of large solutes 154
5.4.1 Albumin leakage and amino acid loss 155
6. Performance-enhancing designs 173
6.1 Constructions for optimising dialysis fluid flow within
the dialyser 173
6.2 Approaches to optimise blood access to the membrane 181
6.3 Changes in fibre geometry and membrane structure
aimed at improving transmembrane transport 185
8
Section C.
Dialyser biocompatibility
7. Basic principles of biocompatibility assessment 199
7.1 Membrane thrombogenicity 200
7.1.1 Platelet activation 203
7.1.2 Coagulation activation and thrombus formation 205
7.1.3 Main anticoagulatory mechanisms 209
7.1.4 The role of anticoagulation in biocompatibility 209
7.1.4.1 Heparin / low molecular weight heparins 210
7.1.4.2 Citrate 212
7.1.4.3 Prostacyclin 213
7.2 Complement activation 213
7.3 Activation of leukocytes 220
7.3.1 Stimulation of neutrophils and monocytes 220
7.3.2.1 Induction of oxidative stress 229
7.3.2.2 Stimulation of cytokine generation 232
7.3.3 Stimulation of basophilic leukocytes and mast cells 237
7.3.4 The role of immune cell stimulation in the generation
of B2-microglobuIin 240
7.3.5 Stimulation of the adaptive (specific) immune system -
hypersensitivity 242
7.4 Activation of the kinin system - anaphylactoid reactions 243
7.5 Bioincompatibility aspects of advanced glycation and oxidation
end-product formation 245
8. Biocompatibility characteristics of dialysers and haemofilters 261
8.1 Thrombogenicity of dialysers 262
8.2. Complement activation by dialysers 268
8.3. Cell activation by dialysers 273
8.3.1 Stimulation of neutrophils and monocytes 274
8.3.1.1 Oxygen species production - Induction of
oxidative stress 279
8.3.1.2 Degranulation of neutrophils 282
8.3.2 Stimulation of cytokine generation by dialysers 284
8.3.3 Effect of dialysers on the acute phase reaction 296
8.4 Activation of the kinin system by dialysers 299
q
Section D.
Clinical experience
9. Acute adverse reactions associated with dialyser choice 315
9.1 Clinical manifestations 318
9.2 Aetiology and prevention 320
9.2.1 Leachables 329
9.2.1.1 Ethylene oxide 329
9.2.1.2 Other chemical residues 333
9.2.1.3 Membrane degradation products 335
9.2.2 Membrane bioincompatibility 335
9.2.2.1 Anaphylactoid reactions 336
9.2.2.2 Dialysis-associated hypoxaemia 344
9.2.2.3 Cardiovascular and other intra- and
postdialytic reactions 346
10. Possible contributions of dialyser characteristics to long-term
problems in ESRD 365
10.1 Pathophysiological pathways common to various diseases 366
10.1.1 Chronic inflammatory state 368
10.1.2 Oxidative stress 379
10.1.3 Carbonyl stress 389
10.2 Malnutrition 393
10.3 Renal anaemia 403
10.4 Loss of residual renal function 410
10.5 Atherosclerosis 413
10.5.1 Plasma lipids 416
10.5.2 Homocysteine 424
10.6 Susceptibility to infection 427
10.7 Amyloidosis 429
10.8 Pruritus 439
10.9 Peripheral nerve function 440
11. Cumulative effects of patient, treatment and device factors
on mortality 477
11.1 Specific ESRD-associated mortality factors 478
11.2 Influence of dialyser and haemofilter characteristics
on mortality 493
10
Section E.
Dialyser reuse
12. Dialyser reuse 511
12.1 Effect of reuse on dialyser performance 518
12.1.1 Main concerns 522
12.2 Effect of reuse on dialyser biocompatibility and
clinical behaviour 525
12.2.1 Open questions 527
Glossary 544
Appendix 1 - Relevant formulae 567
Appendix 2 - List of dialysers and membranes available on the market ...573
Index 597
11
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| illustrated | Illustrated |
| indexdate | 2024-07-10T00:43:29Z |
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| isbn | 3899670051 159326058X |
| language | English |
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| physical | 616 S. Ill., graph. Darst. 21 cm |
| publishDate | 2004 |
| publishDateSearch | 2004 |
| publishDateSort | 2004 |
| publisher | Pabst |
| record_format | marc |
| series | Good dialysis practice |
| series2 | Good dialysis practice |
| spelling | Understanding membranes and dialysers I. Uhlenbusch-Körwer ... Lengerich [u.a.] Pabst 2004 616 S. Ill., graph. Darst. 21 cm txt rdacontent n rdamedia nc rdacarrier Good dialysis practice 5 Literaturangaben The dialyser and its centrepiece, the membrane, play a central role in chronic renal replacement therapy. More than 1000 different types of dialysers are currently available on the market. How are these characterised and how do they differ? What are their special features and how do they contribute to acute and chronic effects in the patient? Is there a link between morbidity and mortality and the use of a particular type of dialyser? This book addresses these questions and attempts answers based on current scientific knowledge. In this context, dialyser development and the basics of filter performance and biocompatibility assessment are reviewed. Hämodialyse (DE-588)4022808-3 gnd rswk-swf Membran (DE-588)4038571-1 gnd rswk-swf Hämodialyse (DE-588)4022808-3 s Membran (DE-588)4038571-1 s DE-604 Uhlenbusch-Körwer, I. Sonstige oth Good dialysis practice 5 (DE-604)BV041263500 5 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=026237282&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Understanding membranes and dialysers Good dialysis practice Hämodialyse (DE-588)4022808-3 gnd Membran (DE-588)4038571-1 gnd |
| subject_GND | (DE-588)4022808-3 (DE-588)4038571-1 |
| title | Understanding membranes and dialysers |
| title_auth | Understanding membranes and dialysers |
| title_exact_search | Understanding membranes and dialysers |
| title_full | Understanding membranes and dialysers I. Uhlenbusch-Körwer ... |
| title_fullStr | Understanding membranes and dialysers I. Uhlenbusch-Körwer ... |
| title_full_unstemmed | Understanding membranes and dialysers I. Uhlenbusch-Körwer ... |
| title_short | Understanding membranes and dialysers |
| title_sort | understanding membranes and dialysers |
| topic | Hämodialyse (DE-588)4022808-3 gnd Membran (DE-588)4038571-1 gnd |
| topic_facet | Hämodialyse Membran |
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