NDT Advance Access published online on April 6, 2005
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfh776
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1 Department of Medicine Area, Nephrology and Dialysis Unit, CTO Hospital, Turin, Italy
* To whom correspondence should be addressed. Background. As removal of pro-inflammatory cytokines is limited in conventional diffusive or convective extracorporeal therapies, we studied in two polysulphone membranes with an industrial albumin sieving coefficient of 0.05 (Type A) and 0.13 (Type B) cytokine (IL-6, IL-8, IL-1 Methods. Cytokine and plasma protein sieving coefficient (SC) and clearance were studied in (i) post-dilutional haemofiltration mode at 20% fixed ultrafiltration rate; (ii) haemodialysis mode (dialysate flow rate of 3 and 5 l/h); and (iii) haemodiafiltration mode (dialysate flow rate of 3 or 5 l/h with 0.5 l/h of ultrafiltrate). Results. In haemofiltration mode both Type A and Type B haemodialysers at QB 150 ml/min exhibited similar median SC nearly up to 1 for IL-1 Conclusions. Our studies show that a mixed convective and diffusive technique ensures high cytokine clearances with an acceptable loss of albumin.
Received July 25, 2004
Accepted February 11, 2005
Original Articles
Tailoring high-cut-off membranes and feasible application in sepsis-associated acute renal failure: in vitro studies
2 Laboratory of Renal Immunopathology, Department of Internal Medicine, University of Turin, Turin, Italy
3 Fresenius Medical Care, Bad Homburg, Germany
4 Department of Nephrology, S. Bortolo Hospital, Vicenza, Italy
Filippo Mariano, E-mail: filippo.mariano{at}poste.it
Abstract 
, IL-1ra, TNF-
) and plasma protein (albumin, cystatin C, total proteins) permeability profiles. Based on the convective membrane permeability, we evaluated in vitro the dialytic modality that could provide an acceptable balance between high cytokine and low albumin clearances. and IL-1ra, at about 0.6 for IL-6, 0.4 for IL-8 and 0.7 for TNF-, with clearance values ranging from 15 to 30 ml/min. SC were independent of blood flow and were stable throughout the whole experiment. Albumin SC was higher in Type B than in Type A and rapidly decreased from 0.2 to 0.02 and from 0.5 to 0.04 within 3 h for haemodialyser Types A and B, respectively. Cytokine SC was lower in haemodialysis than in haemodiafiltration and haemofiltration mode, and by increasing dialysate flow from 3 up to 5 l/h in both haemodialysis and haemodiafiltration mode, SC for all tested cytokines decreased. However, at 5 l/h clearances were not different or were higher, since increased amounts of dialysate outlet compensated for the decreased SC. Albumin clearances in haemodialysis and haemodiafiltration mode after 360 min at 5 l/h were 0.81 and 0.91 ml/min, respectively.
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