Figure 66

High-efficiency and high-flux membranes in hemodialysis. These membranes have similar clearance values for low molecular weight solutes such as urea (molecular weight, 60). In this respect both types of membranes have similar KoA values (over 600 mL/min), where KoA is the constant indicating the efficiency of the dialyzer in removing urea. As a result of increased pore size, use of high-flux membranes can lead to significantly greater clearance rates of high molecular weight solutes. For example, ^-microglobulin is not removed during dialysis using low-flux membranes (KUf <10 mL/h/mm Hg, where KUf is the ultrafiltration coefficient). With some high-flux membranes, 400 to 600 mg/wk of ^-microglobulin can be removed. The clinical significance of enhanced clearance of ^-microglobulin and other middle molecules using a high-flux dia-lyzer is currently being studied in a national multicenter hemodial-ysis trial.

Number of hemodialysis treatments
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