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Dialyse aktuell 2015; 19(08): 416-422
DOI: 10.1055/s-0041-102390
Dialyse
© Georg Thieme Verlag Stuttgart · New York

Neue Dialysefilter und -techniken – Verbesserte Elimination von Urämietoxinen

New dialysis filters and techniques – Improved elimination of uremic toxins
Markus van der Giet
1   Med. Klinik mit SP Nephrologie, Campus Benjamin Franklin, Charité – Universitätsmedizin Berlin (Klinikdirektor: Prof. Dr. Walter Zidek)
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Publication History

Publication Date:
10 November 2015 (online)

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Zusammenfassung

Seit über 70 Jahren wird systematisch an der Entwicklung und Optimierung von Dialysemembranen gearbeitet. Vor allem durch technologische Entwicklungen der letzten Jahrzehnte sind optimierte Membran-Produktions-Möglichkeiten geschaffen worden. Vom Grundprinzip her funktioniert die Dialysemembran nach dem physikochemischen Prinzip der Diffusion und der Konvektion. Viele bei der Urämie akkumulierende Substanzen (Urämietoxine), wie vor allem eiweißgebundene Substanzen, sind aber mit den konventionell eingesetzten Techniken derzeit nicht zu eliminieren. Hier ist potenziell die Adsorption eine Möglichkeit zur Elimination von eiweißgebundenen Urämietoxinen. In den letzten Jahren wird zunehmend erkannt, dass auch bereits die eingesetzten Filter in der Lage sind, zu adsorbieren. Dies ist aber nicht gerichtet, sondern eher zufällig. Es wird derzeit an Methoden gearbeitet, welche die Adsorption systematisch etablieren sollen, um damit auch die eiweißgebundenen Urämietoxine zu eliminieren. Diese Übersicht fasst die derzeitigen Entwicklungen zusammen.

Summary

For more than 70 years, there is a systematic development program to establish optimal dialysis membranes. Many technological advances have been performed to optimize the generation of membranes. Today, the basic principle of dialysis membranes is based on diffusion and convection. Many substances accumulating in uremia, the so-called uremic toxins, cannot be eliminated efficiently by current dialysis modalities. Potentially, adsorption techniques might overcome this problem. Over the last years, there is a progressive attention to adsoprtion techniques. Many dialysis membranes that are used have some adsorption properties which are unfocussed. Currently, new methods are tested to systematically use adsorption techniques in combination with conventional dialysis in order to enhance uremic toxin elimination. This review gives a short overview on the current developments.

Key words

dialysis - filters - techniques - elimination - uremic toxins
 

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