Background: For blood purification systems using a semipermeable membrane, the\r\nconvective mass transfer by ultrafiltration plays an important role in toxin removal. The\r\nincrease in the ultrafiltration rate can improve the toxin removal efficiency of the device,\r\nultimately reducing treatment time and cost. In this study, we assessed the effects of\r\npulsatile flow on the efficiency of the convective toxin removal in blood purification\r\nsystems using theoretical methods.\r\nMethods: We devised a new mathematical lumped model to assess the toxin removal\r\nefficiency of blood purification systems in patients, integrating the mass transfer model for\r\na human body with a dialyser. The human body model consists of a three-compartment\r\nmodel of body fluid dynamics and a two-compartment model of body solute kinetics. We\r\nsimulated three types of blood purification therapy with the model, hemofiltration,\r\nhemodiafiltration, and high-flux dialysis, and compared the simulation results in terms of\r\ntoxin (urea and beta-2 microglobulin) clearance and the treatment dose delivered under\r\nconditions of pulsatile and non-pulsatile pumping. In vivo experiments were also\r\nperformed to verify the model results.\r\nResults: Simulation results revealed that pulsatile flow improved the convective clearance\r\nof the dialyser and delivered treatment dose for all three types of therapy. Compared with\r\nthe non-pulsatile pumping method, the increases in the clearance of urea and beta-2\r\nmicroglobulin with pulsatile pumping were highest with hemofiltration treatment (122.7%\r\nand 122.7%, respectively), followed by hemodiafiltration (3.6% and 8.3%, respectively), and\r\nhigh-flux dialysis (1.9% and 4.7%, respectively). EKRc and std Kt/V averaged 28% and 23%\r\nhigher, respectively, in the pulsatile group than in the non-pulsatile group with\r\nhemofiltration treatment.\r\nConclusions: The pulsatile effect was highly advantageous for all of the toxins in the\r\nhemofiltration treatment and for �Ÿ2-microglobulin in the hemodiafiltration and high-flux\r\ndialysis treatments.
Loading....