In Vivo Clearance and Elimination of Nine Marker Substances during Hemofiltration with Different Membranes

Abstract

The handling of low, middle and high molecular weight markers was examined in seven stable dialysis patients during hemofiltration with different membranes. Four membranes were examined in a randomized, crossover order (polysulfone, polyamide, AN69 polyacrylonitrile, Asahi polyacrylonitrile) by measuring plasma and dialysate concentrations of phosphate, creatinine, vitamin B₁₂, β₂-microglobulin, furanic acid, hippuric acid, retinolbinding protein, alpha-1-antitrypsin, and albumin. Sieving coefficients and plasma clearances of β-microglobulin or retinol-binding protein were markedly or slightly lower during hemofiltration with the Asahi polyacrylonitrile membrane than with the other membranes (highest removal with polysulfone/AN69 polyacrylonitrile membranes). No differences of obvious clinical relevance could be seen between the four membranes. A high β₂-microglobulin removal rate might be important to prevent dialysis-associated amyloidosis.