The Sorbent Suspension Reciprocating Dialyzer for Use in Peritoneal Dialysis
The greatest cost of peritoneal dialysis is in the preparation, packaging, and shipping of sterile dialysis fluid. CAPD and CCPD represent attempts to support patients on the minimal volumes of such dialysis fluid. Sorbent chemicals which regenerate dialysate could decrease the shipping weight of disposables, while allowing much higher dialysate flows.
A plate dialyzer with screen supports has been designed which can operate with a thick sorbent suspension on the screen side (SSRD). The sorbent suspension contains charcoal, covalently-bound urease, calcium-loaded zeolites, and hydrogen-loaded cation exchangers. Alteration in pressure of the sorbent suspension propels 200 ml of peritoneal dialysate into and out of the dialyzer (through a single central port), where it lies directly across the membrane from the sorbent suspension. In tests of the SSRD on dogs with BUN 50–60 mg/dl and plasma creatinine 6 mg/dl, the clearances, of urea and creatinine were 80–100 ml/min, phosphorus was 50, and K was 20 ml/min for 4 hours. These clearances are high enough to maintain low concentrations of urea, creatinine, phosphorus and K in the peritoneal dialysate. Protein is not removed, and calcium and bicarbonate are returned to the animal. Ultrafiltration ranged from 0.2–0.8 L/h. Protein removal is entirely avoided. The sorbent suspension need not be sterile. If sorbent components can be made at moderate cost, the SSRD may be a simple, cost effective method of intermittent peritoneal dialysis.
KeywordsCellulose Catheter Phosphorus Urea Creatinine
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