New artificial kidney models and new synthetic membranes with high permeability developed and reduced to clinical practice in the last few decades gave rise to a variety of methods of extracorporeal blood clearance based on convective and convective---diffusive mass transfer through the dialysis membrane. Generally, these methods provide more efficacious blood clearance and are more comfortable than conventional hemodialysis.Acetate-Bee biofiltration (AFBF) was proposed in 1985 as a method of treatment of renal insufficiency [4]. It is a version of the method of hemodiaffitration, Acetate-free biofiltration can be implemented in a high-permeability dialyzer using buffer-Bee dialyzate. Isotonic (1.35%) sodium hydrocarbonate (SH) solution is used as a replacing liquid. It also provides correction of acidosis. Although biofiltration is more efficacious than conventional hemodialysls and avoids adverse side effects of acetate on blood [3, 5], it has not yet received wide acceptance in Russia because of lack of special equipment and replacing solutions. The method of AFBF developed in our laboratory [1] can be implemented using rather common equipment and does not require commercial isotonic SH solution. According to this method, SH solution can be sterilized by filtration through a high-permeability dialyzer and used as a replacing liquid. However, in addition to artificial kidney, implementation of this method requkes two expensive high-permeability dialyzers (one in the replacing liquid flow loop and the other in the blood flow loop) and two pumps in the replacing liquid flow loop. That is why the method described in [1] is not widely used in clinical practice. To make this method more appropriate for common clinical practice, it has been modified in our laboratory (Fig. 1).The scheme shows that both dialysis and ultrafiltration of the patients' blood are implemented by conventional methods. Reinfusion of SH solution is performed as follows: 10 liters of 1.35% SH solution are prepared in a pretreated container (9) immediately before the procedure. The hydrocarbonate solution is pumped by independent standard roller pumps (5) to the venous traps (6) of the blood-conducting pipes of patients. The hydrocarbonate solution filtered through a dialyzer membrane (4) becomes sterile and apyrogenic. The sterilizing dialyzer membrane is safe against rupture, because filtration is performed into
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