Gambro filter(disposable parallel flow dialyzer)の使用経験

Abstract

Gambro filter (disposable parallel flow dialyzer, Alwall model) was used for hemodialysis on 10 patients with chronic renal failure on whom regular intermittent dialysis with Kiil dialyzer had been conducted over one year. The filter was compared with the standard 2-layers Kiil dialyzer regarding dialysance. 1) In order to extract the same amount of water, negative pressure given on the dialysis fluid had to be doubled in Gambro filter as compared with Kiil dialyzer. For example, to extract water of 200 g per hour, negative pressure of 180 to 200 mmHg was necessary in Gambro filter, whereas 100 to 120 mmHg in Kiil dialyzer. 2) Dialysance of the various substances was as follows. The dia, lysances by Gambro filter are inferior to those by the standard Kolff twin coil, but they are better as much as 10 % than those by Kiil dialyzer in urea nitrogen and creatinine. As to dialysance of NPN and uric acid, there was almost no difference between Gambro and Kiil. 3) Changes in dialysance according to time were as follows. Reduction of dialysance may be explained by 1) drop of concentration gradient in andout of the dialysis membrane, 2) reduced dialyzing surface due to obstructed mesh caused by leukocytic adhesion, and reduced blood flow due to lowering blood pressure resulting from water extraxtion by ultrafiltration. 4) Gambo filter is compact and ready to use, does not need a blood pump, needs only small volume of priming blood, and leaves residual blood of very small amount. Another advantage of this filter is that the medical staffs are required much less contact with the patients' blood and dialysis hepatitis may be prevented. No pyrogenic reaction or blood leakage was observed during hemodialysis with Gambro filter. Gambro filter will be widely used if it becomes more inexpensive or accepted by socio-medical care in Japan.