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Extrakorporale Blutreinigungssysteme

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Medizintechnik

Zusammenfassung

Die Pioniere auf dem Gebiet der Blutreinigungssysteme häten es sich sicher nicht trämen lassen, dass im Jahr 2010 weltweit etwa 1,8 Millionen nierenkranke Patienten einer standardisierten Blutwäche mit dialytischen Verfahren ihr Leben verdanken. Dies ist besonders dann zu bedenken, wenn man die in den Anfägen der Forschung üer extrakorporale Blutkreisläufe als unüerwindlich scheinenden technischen Schwierigkeiten zugrunde legt. Eine Routinebehandlung mit der küstlichen Niere war nicht vorstellbar, der berümte Mediziner Franz Volhard hatte diese gar in den 1920er Jahren als nutzlos und gefärlich bezeichnet.

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Literatur

  1. Kramer A, Stel V, Zoccali C, Heaf J, Ansell D, Grönhagen-Riska C, Leivestad T, Simpson K, Palsson D, Postorino M, Jager K (2009) An update on renal replacement therapy in Europe: ERA-EDTA REgistry data from 1997–2006. Nephrol Dial Transplant 24:3557–3566

    Article  Google Scholar 

  2. Goddemeier C (2007). Die Entdeckung des Blutkreislaufs. Deutsches Ärztebl 104:1168–1170

    Google Scholar 

  3. Graham T (1854) The Bakerian lecture: on osmotic forces. Phil Trans Royal Soc, London 144:177–228

    Article  Google Scholar 

  4. Fick A (1855) Über Diffusion. Ann Phys Chem 94:59–86

    Article  Google Scholar 

  5. Schumacher W (1860) Über Membrandiffusion. Ann Phys Chem 110:337–370

    Article  Google Scholar 

  6. Eggerth A (1921) The preparation and standardisation of collodion membranes. J Biol Chem 18: 203–221

    Google Scholar 

  7. Abel J, Rowntree L, Turner B (1913) On the removal of diffusible substances from the circulating blood of living animals by means of dialysis. J Pharmacol Exp Ther 5: 275–283

    Google Scholar 

  8. International Standard Organisation, ISO 10993–16 (1997). Biological evaluation of medical devices, Part 16. Toxicokinetic study design for degradation products and leachables.

    Google Scholar 

  9. Haas G (1923) Dialysieren des strömenden Bluts am Lebenden. Klin Wochenschr 2:1888

    Article  Google Scholar 

  10. Haas G (1928) Über Blutwaschung. Klin Wochenschr 7: 1356™ 1362

    Article  Google Scholar 

  11. Kolff W, Berk H,Ter Welle M, van der Leij J, van Dijk E, van Nordwijk J (1944) The artificial kidney: a dialyser with a great area. Acta Med Scand 117:121–134

    Article  Google Scholar 

  12. Lonnemann G (2000). The quality of dialysate: an integrated approach. Kidney Int S 112–119.

    Google Scholar 

  13. Henrie M, Ford C, Andersen M, Stroup e, Diaz-Buxo J, Madsen B, Britt D, Chih-Hu H (2008). In vitro assessment of dialysis membrane as an endotoxin transfer barrier: geometry, morphology, permeability. Artif Organs 32: 701–710.

    Article  Google Scholar 

  14. Kessler M, Canaud B, Pedrini L, Tattersall J, ter Wee P, Vanholder R, Wanner C (2002) European best practice guidelines for haemodialysis (Part 1). Biocompatibility. Nephrol Dial Transplant 17 (Suppl 7): 32–44

    Google Scholar 

  15. Ansorge W, Pelger M, Dietrich W, Baurmeister U (1987). Ethylene oxide in dialyser rinsing fluid: effect of rinsing technique, dialyser storage time and potting compound. Artif Organs 11:188–122

    Article  Google Scholar 

  16. Lemke H (1987). Mediation of hypersensitivity reactions during hemodialysis by IgE-antibodies against ethylene oxide. Artif Organs 11: 104–110

    Article  Google Scholar 

  17. Vienken J, Ronco C (2001). New developments in hemodialysers. Contr Nephrol 133:105–118

    Article  Google Scholar 

  18. Gotch F, Peter H, Panilio F, Folden T, Keen M (1995). Online measurement of delivered kt/V during dialysis. J Am Soc Nephrol 6: 600

    Google Scholar 

  19. National Kidney Dialysis Outcome Quality Initiatve (DOQI) (1997). Clinical Practice guidelines: hemodialysis adequacy and peritoneal dialysis adequacy. Am J Kidney Dis 30 (Suppl 2): S1-64

    Google Scholar 

  20. Kuhlmann U, Goldau R, Samadi N, Graf T, Gross M, Orlandini G, Lange H (2001). Accuracy and safety of online clearance monitoring based on conductivity variation. Nephrol Dial Transplant 16: 1053–1058

    Article  Google Scholar 

  21. Gotch F. Sargent J, Keen M (2000). Whither goest Kt/V?. Kidney Int 58(Suppl76):S3–18.

    Article  Google Scholar 

  22. Vanholder R und die Eutox Gruppe (2003). Review on uremic toxins: classification, concentration and interindividual variability. Kidney Int 63:1934–1943

    Google Scholar 

  23. Lysaght M (1988). Hemodialysis membranes in transition. Contrib Nephrol 61:1–17

    Google Scholar 

  24. Ronco C, Ghezzi P, Hoenich N, Delfino P (2001). Computerized selection of membranes and hemodialysers. Contrib Nephrol 133: 119–130

    Article  Google Scholar 

  25. Dialysestandard der Arbeitsgemeinschaft klinische Nephrologie e.V. und der Dialysegesellschaft niedergelassener Ärzte e.V. (2000)

    Google Scholar 

  26. Clark W, Hamburger R, Lysaght M (1999). Effect of membrane composition and structure on solute removal and biocompatibility. Kidney Int 56: 2005–2015

    Article  Google Scholar 

  27. Leypoldt J, Schmidt B, Gurland HJ (1991). Measurement of backfiltration rates during hemodialysis with highly permeable membranes. Blood Purif 9: 74–84

    Article  Google Scholar 

  28. Leypoldt J, Schmidt B, Gurland HJ (1991). Net ultrafiltration may not eliminate backfiltration during hemodialysis with highly permeable membranes. Artif Organs 15:164–170

    Article  Google Scholar 

  29. Sargent J, Gotch F (1996). Principles and biophysics of dialysis. In: Jacobs C, Kjellstrand C, Koch K, Winchester J (eds) Replacement of renal function by dialysis, 4th ed. Dordrecht, Kluwer Academic Publishers: pp 188–230

    Google Scholar 

  30. Vanholder R, Meert N, Schepers E, Glorieux G.(2008).Uremic toxins: do we know enough to explain uremia? Blood Purif 26: 77–81

    Article  Google Scholar 

  31. Leber HW, Wizemann V, Goubeaud G, Rawer P, Schütterle G. (1978). Simultaneous hemofiltration/hemodialysis: an effective alternative to hemofiltration and conventional hemodialysis in the treatment of uremic patients. Clin Nephrol 9:115–121

    Google Scholar 

  32. Henderson LW, Sanfelippo ML, Beans E (1978). »On line« preparation of sterile pyrogenfree electrolyte solution. Trans Am Soc Artif Intern Organs 24:465–7

    Google Scholar 

  33. Polaschegg H (1993) Automatic, noninvasive intradialytic clearance measurement. Int J Artif Organs 16:185–191

    Google Scholar 

  34. Polaschegg HD, Roy T (2007) Technical aspects of online hemodiafiltration. Contrib Nephrol 158:68–79

    Article  Google Scholar 

  35. Canaud B, Bragg-Gresham J, Marshall M, Desmeules S, Gillespie B, Depner T, Klassen P, Port F (2006). Mortality risk for patients receiving hemodiafiltration versus hemodialysis: European results from the DOPPS. Kidney Int 69: 2087–93

    Article  Google Scholar 

  36. Krämer M. (2006). Physiological monitoring and control in hemodialysis: state of the art and outlook. Expert Rev Med Devices 3: 617–34

    Article  Google Scholar 

  37. Maggiore Q, Pizzarelli F, Santoro A, Panzetta G, Bonforte G, Hannedouche T, Alvarez de Lara MA, Tsouras l, Loureiro A, Ponce P, Sulkova S, Van Roost G, Brink H, Kwan JT (2002) Study group of thermal balance and vascular stability. The effects of control of thermal balance on vascular stability in hemodialysis patients: results of the European randomized clinical trial. Am J Kidney Dis 40: 280–90

    Article  Google Scholar 

  38. Santoro A, Mancini E, Basile C, Amoroso L, DiGiulio S, Usberti M, Colasanti G, Verzetti G, Rocco A, Imbasciati E, Panzetta G, Bolzani R, Grandi F, Polacchini M (2002) Blood volume controlled hemodialysis in hypotension-prone patients: a randomized, multicenter controlled trial. Kidney Int 62:1034–45

    Article  Google Scholar 

  39. Kraemer M, Rode C, Wizemann V (2006) Detection limit of methods to assess fluid status changes in dialysis patients. Kidney Int 69:1609–1620

    Article  Google Scholar 

  40. Fagugli RM, Pasini P, Pasticci F, Ciao G, Cicconi B, Buonchristiani U (2006). Effects of short daily hemodialysis and extended standard hemodialysis on blood pressure and cardiac hypertrophy: a comparative study. J Nephrol 19: 77–83

    Google Scholar 

  41. Chamney P, Wabel P, Moissl U, Müller M, Bosy-Westphal A, Korth O, Fuller N (2007). A whole-body model to distinguish excess fluid from the hydration of major body tissues. Am J Clin Nutr 85: 80–89

    Google Scholar 

  42. Cole KS, Cole RH (1941) Dispersion and adsorption in dielectrics. J Chem Phys 9:341–351

    Article  Google Scholar 

  43. Moissl UM, Wabel P, Chamney P, Bosaeues l, Levin N, Bosy-Westphal A et al. (2006) Body fluid volume determination via body composition spectroscopy in health and disease. Physiol Meas 27: 921–933

    Article  Google Scholar 

  44. Wabel P, Chamney P, Moissl U, Jirka T (2009). Importance of whole-body bioimpedance spectroscopy for the management of fluid balance. Blood Purif 27: 75–80

    Article  Google Scholar 

  45. Wabel P, Moissl U, Chamney P, Jirka T, Machek P, Ponce P et al. (2008) Towards improved cardio-vascular management: the necessity of combining blood pressure and fluid overload. Nephrol Dial Transplant 23: 2965–2971

    Article  Google Scholar 

  46. Wizemann V, Wabel P, Chamney P, Zaluska W, Moissl U, Rode C et al. (2009) The mortality risk of overhydration in haemodialysis patients. Nephrol Dial Transplant 24:1574–1579

    Article  Google Scholar 

  47. Newsweek Magazine (2002) Hepatitis C. The insidious spread of a killer virus. Ausgabe vom 20. Mai, pp 75–79

    Google Scholar 

  48. Leigh JP, Bowlus CL, Leistikow BN, Schenker M (2001) Cost of hepatitis C. Arch Intern Med 161: 2231–3

    Article  Google Scholar 

  49. Konstantin P, Chang J, Otto V, Brunner G (1992). Artificial Liver. Artif Organs 16: 235–242

    Article  Google Scholar 

  50. Mitzner S, Stange J, Klammt S, Peszynski P, Schmidt R Nölde-Schomburg G (2001) Extracorporeal detoxification using the molecular adsorbent recirculating system for critically ill patients with liver failure. J Am Soc Nephrol 12 (Suppl 1): S75-S82

    Google Scholar 

  51. Vienken J, Christmann H (2006) How can liver toxins be removed? Filtration and adsorption with the Prometheus System. Ther Aph Dial 10:125–131

    Article  Google Scholar 

  52. Stange J, Mitzner S (1996). A carrier-mediated transport of toxins in a hybrid membrane: safety barrier between a patient's blood and a bioartificial liver. Int J Artif Organs 19: 677–691

    Google Scholar 

  53. Rifai K, Ernst T, Kretschmer U, Hafer C, Haller H, Manns MP, Fliser D (2005) The Prometheus device for extracorporeal support of combined liver and renal failure. Blood Purif 23: 298–302

    Article  Google Scholar 

  54. Rifai K, Hafer C, Rosenau J, Athmann C, Haller H, Manns MP, Fliser D (2006) Treatment of severe refractory pruritus with fractionated plasma separation and adsorption (Prometheus). Scand J Gastroenterol 41:1212–1217

    Article  Google Scholar 

  55. Stange J, Mitzner S, Risler T, Erley C, Lauchart W, Goehl H, Klammt S, Peszynski P, Freytag J, Hickstein H, Löhr M, Liebe S, Scharek W, Hopt U, Schmidt R (1999) Molecular adsorbent recycling system (MARS): clinical results of a new membrane-based blood purification system for bioartificial liver support. Artif Organs 23: 319–330

    Article  Google Scholar 

  56. Heemann U, Treichel U, Loock J, Philipp T, Gerken G, Malago M, Klammt S, Loehr M, Liebe S, Mitzner S, Schmidt R, Stange J (2002) Albumin dialysis in cirrhosis with superimposed acute liver injury: a prospective controlled study. Hepatology 36: 949–958

    Google Scholar 

  57. Hartmann J, Strobl K, Falkenhagen D (2008) Anticoagulation in combined membrane/adsorption systems. Contributions, Sec Biol Med Sci, MASA 2:39–49

    Google Scholar 

  58. Herget-Rosenthal S,Treichel U, Saner F (2003) Citrate anticoagulated modified fractionated plasma separation and adsorption: first clinical efficacy and safety data in liver failure. J Am Soc Nephrol 14:729A

    Google Scholar 

  59. Kozik-Jaromin J, Nier V, Heemann U. Kreymann B, Boehler J (2009) Citrate pharmacokinetics and calcium levels during highflux dialysis with regional citrate anti-coagulation. Nephrol Dial Transplant 24: 2244–2251

    Article  Google Scholar 

  60. Janssen M, Deegens J, Kapinga T, Beukhof J, Huijgens P, van Loenen A, van der Meulen J (1996) Citrate compared to low molecular weight heparin anticoagulation in chronic hemodialysis patients. Kidney Int 49:806–813

    Article  Google Scholar 

  61. Kjaergard L, Liu J, Als-Nielsen B, Gluud C (2003) Artificial and bioartificial support systems for acute and acute-on-chronic liver failure. JAMA 289: 217–222

    Article  Google Scholar 

  62. European Commission (2007) Regulation (EU) No 1394/2007 of the European Parliament and of the Council of November 13, 2007 on Advanced Therapy Medicinal Products. Official J European Union, L324/121 vom 10.12.2007

    Google Scholar 

  63. Kramer A, Stel V, Zoccali C, Heaf J, Ansell D, Grönhagen-Riska C et al. (2009) An update on renal replacement therapy in Europe: ERA-EDTA registry data 1997–2006. Nephrol Dial Transplant 24: 3557–3566

    Article  Google Scholar 

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Vienken, J. (2011). Extrakorporale Blutreinigungssysteme. In: Kramme, R. (eds) Medizintechnik. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-16187-2_29

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