Manual single lumen alternating micro-batch dialysis achieves reliable clearance via diffusion

Ceschia, Giovanni; Chawla, Apaara K.; Morgan, Jolyn; Rose, James E.; Goldstein, Stuart L.; Hasson, Denise C.

doi:10.1038/s41390-023-02636-9

Cited by 3 publications

(4 citation statements)

References 5 publications

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“…From a safety perspective, they did encounter inconsistencies controlling active ultra ltration when small protocol steps were omitted/forgotten, which ultimately led to excess uid removal [8]. Gravity driven ultra ltration and ow can be di cult to control precisely and introduces room for error, as we have experienced and reported in our prior mSLAMB experiments [7]. The Kirpa Kit™ relies on small-batch syringe ow, which eliminates passive ultra ltration and achieves precise active ultra ltration, thus greatly reducing the risk of excess ultra ltration and subsequent hemodynamic instability.…”

Section: Discussionmentioning

confidence: 99%

“…The volume of blood drawn from the Blood Bag at each cycle, called the Blood Batch, was 100 mL (16% of the Blood Bag) for the Prototype mSLAMB and the Single Pass mSLAMB, while the Blood Batch for the Kirpa Kit™ was 60 mL (10% of the Blood Bag), based on their respective extracorporeal volumes (including 52 mL hemo lter volumes). The structure and the ow-path of the Prototype mSLAMB and the Single Pass mSLAMB have been described previously [7]. Dialysis uid and E uent bags were placed at speci c heights to negate passive ultra ltration for both mSLAMB set-ups.…”

Section: Experimental Con Gurationsmentioning

confidence: 99%

“…1b), decreasing the cycle time and reducing the risk of clotting during the second pass through the hemo lter. Preliminary data demonstrated that the single pass mSLAMB outperformed the prototype [7].…”

Section: Introductionmentioning

confidence: 98%

“…This inexpensive platform provides manual dialysis that functions without the need for electricity, batteries, or pump. The technique is simple and can effectively remove small solutes (urea and potassium) via convection and diffusion and reliably perform ultra ltration in in vitro experiments [6,7]. We previously identi ed limitations of the mSLAMB technique, namely that uid ow is gravity dependent, necessitating careful monitoring and manipulation of con guration heights to control blood ow rate and ultra ltration.…”

Section: Introductionmentioning

confidence: 99%

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An update to the mSLAMB dialysis device (the “Kirpa Kit”): An in-vitro comparison of efficiency

Ceschia,

Slagle,

Morgan

et al. 2024

Preprint

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Background Access to pediatric dialysis is challenged in low-resource settings by high costs, scarcity of equipment, and lack of qualified personnel availability. We demonstrated the manual Single Lumen Alternating Micro-Batch (mSLAMB) device can remove small solutes in vitro without the need for electricity, batteries or pumps. We developed a new version (Kirpa Kit™) to address some of the technical limitations of mSLAMB. Here we compare the in vitro clearance performance and ease of use of Kirpa Kit™ with that of prior mSLAMB configurations. Methods A mixture of expired packed red blood cells, 0.9% NaCl, urea and heparin was used to test the efficiency of two mSLAMB configurations and Kirpa Kit™ in removing potassium and urea. Clearance was evaluated by measuring percent reduction after 25-minute sessions with each device. A survey was used to evaluate the ease of use of each configuration. Results The Kirpa Kit™ achieved a median urea reduction of 82.4% and potassium reduction of 82.1%, which were higher than those achieved with the best-performing mSLAMB configuration (urea 71.9%, potassium 75.4%). The Kirpa Kit™ was easier to use with a shorter perceived time of use than the mSLAMB. Conclusions The Kirpa Kit™, evolution of mSLAMB, is easy to use and may have improved efficacy, making it an optimal candidate for in vivo testing.

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Section: Discussionmentioning

confidence: 99%

Section: Experimental Con Gurationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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