Effect of High Fiber Density Ratio Polysulfone Dialyzer on Protein Removal.

Background/Aims: A dialyzer (APS-EX) with a higher hollow fiber density ratio was manufactured using the highest performance polysulfone hollow fiber from Asahi- Kasei Medical. Methods: We compared the performance of this device in comparison with hemodialysis (HD; APS-S) and hemodiafiltration (HDF) conditions (APS-S, 10 I post-HDF) to evaluate its merit as an internal filtration- enhanced dialyzer. Results: With low molecular weight proteins, APS- EX had a reduction ratio of 74.3% for beta(2)-microglobulin (beta(2)-MG), and 31.0% for alpha(1)-MG. APS- EX had a significant higher removal amount of alpha(1)-MG compared to APS-S (HDF). Significant differences were seen in albumin loss, 4.0 g for APS-EX, 3.0 g for APS- S (HDF), and 0.9 g for APS-S (HD). Using HD mode, APS-EX demonstrated a performance which was more than equivalent to approximately 10 I post- HDF. Conclusions: The results suggested the possibility that HD equivalent to HDF can be performed safely with the ultrapure dialysate when using APS- EX with internal filtration. Copyright (c) 2008 S. Karger AG, Basel.