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Abstract: SA-PO1076

Enhancement of Solute Clearance Using an Experimental Pulsatile Push Pull Dialysate Flow Mode for the Quanta SC+: A Novel Clinic-to-Home Hemodialysis System

Session Information

  • Home Hemodialysis
    November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 702 Dialysis: Home Hemodialysis

Authors

  • Buckberry, Clive, Quanta Dialysis Technologies, Alcester, United Kingdom
  • Krieter, Detlef H., University Hospital Würzburg, Würzburg, Germany
  • Komenda, Paul, Quanta Dialysis Technologies, Alcester, United Kingdom
  • Lemke, Horst-Dieter, University Hospital Würzburg, Würzburg, Germany
  • Milad, John, Quanta Dialysis Technologies, Alcester, United Kingdom
Background

The SC+ hemodialysis system is a small, easy to use dialysis system designed to improve patient access to self care and home hemodialysis. A prototype of the SC+ device with a pulsatile push pull dialysate flow was developed for evaluation purposes.

Methods

The pumping action of the prototype SC+ system was modified by altering software algorithms controlling the sequencing and timings of the valves and pumps associated with the flow balancing chambers that push and pull dialysis fluid to and from the dialyzer; no additional modifications to the hardware or consumables were required. Solute clearance performance was assessed in the prototype SC+ system across a range of molecular weights in two related series of laboratory bench studies. The first measured dialysis fluid moving across the dialyzer membrane using ultrasonic flowmeters to establish the validity of the approach; solute clearance was subsequently measured using fluorescently tagged dextran molecules as surrogates for uremic toxins. The second study used human blood doped with uremic toxins. In both, the performance of the SC+ prototype was assessed alongside reference devices operating in HD and pre-dilution hemodiafiltration (HDF) modes.

Results

Initial testing with fluorescein-tagged dextran molecules (0.3 kDa, 4 kDa, 10 kDa and 20 kDa) established the validity of the experimental pulsatile push-pull operation in the prototype SC+ system to enhance clearance and demonstrated a 10 to 15% improvement above the current HD mode used in clinic today.
Additional testing using human blood indicated a comparable performance to pre-dilution HDF.

Conclusion

The observed enhancement of solute transport is attributed to the disruption of the boundary layers at the fluid-membrane interface which, when used with blood, minimizes protein fouling and maintains the surface area available for mass and fluid transport.
In contrast with current HDF technologies, this improvement in performance has been achieved without the introduction of any additional complexity to the device hardware or fluidic circuit consumable sets maintaining ease of use of the SC+ system.

Funding

  • Commercial Support –