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Kidney Week

Abstract: SA-PO558

Improving the Efficacy and Efficiency of Hemodialysis by Adding Nanoscale Activated Carbon (Nano-Slurry) Sorbent to the Dialysate

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Tehrani, Rouzbeh, Temple University, Philadelphia, Pennsylvania, United States
  • Gillespie, Avrum, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, United States
  • Alderfer, Juliana, Temple University, Philadelphia, Pennsylvania, United States
Background

Improving the efficacy and efficiency of dialysate for hemodialysis has the potential to improve patient outcomes and reduce waste and energy consumption. Currently, hemodialysis relies mostly on diffusive clearance across a gradient between the patient’s blood and the dialysate. We demonstrate that the addition of nanoparticle sorbents to the dialysate can improve the efficiency of hemodialysis and can allow for the reuse of dialysate.

Methods

This is an in-vitro hemodialysis experiment using Li-heparinized porcine blood, two peristaltic pumps, Fresenius Optiflux hemodialysis membranes, and CitraPure dialysate concentrate (Rockwell Medical) which was diluted and the pH was adjusted using medical-grade sodium bicarbonate (Solcart B, B.Braun). One liter of freshly collected porcine blood was dialyzed with an average blood flow rate of 30 mL/min and dialysate flow of 50 mL/min. Nanoscale activated carbon (Nano-Slurry) was tested in this study. The mass of added adsorbents (0.5 to 5 g/l) varied depending on the adsorbent type, targeted blood toxin, and expected removal rate. Absorbent leaching to blood was tested by using highly concentrated Nano-Slurry (10 to 20 g/l) dialysate and increased transmembrane pressure by increasing the dialysate flow rate to 1000 mL/min and measuring the reverse filtrate for nanoparticles by turbidity with a near-infrared turbidity meter.

Results

In the single-pass experiment, creatinine was removed in half the time when using Nano-Slurry dialysate. We then did our recirculated dialysate experiment and the Nano-Slurry, creatinine rapidly equilibrated in the control experiment at 30 minutes whereas, the recirculated Nano-Slurry dialysate continued to remove creatinine at the end of the experiment, 100 minutes. BUN rapidly lowered from 17 mg/dL to 7mg/dL, below the calculated equilibrium at 20 minutes. For the absorbent leaching experiment, the reverse filtrate had turbidity that remained unchanged pre- and post-experiment with a measure of 0.03 NTU.

Conclusion

Nano-Slurry improved the efficiency in both in-vitro single pass and recirculated hemodialysis models. The addition of nanoscale adsorbents improved the efficiency of dialysis and can be incorporated into a novel hemodialysis machine that can recirculate dialysate, reducing water consumption for both in-center and home hemodialysis.