Polymethylmethacrylate Membrane Dialyzer: Historic but Modern

Torii, Y.; Yamada, Satoko; Yajima, Mayumi; Sugata, Toru

doi:10.1159/000526996

Cited by 4 publications

(5 citation statements)

References 32 publications

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“…PMMA membrane is a synthetic polymer membrane with a homogeneous symmetric structure and larger pores on the inner surface. A few studies suggested removing a wide range of proteins by adsorption in addition to diffusion and filtration with hemodialysis using PMMA membranes [12,14]. Our results showed that the removal of β 2 -m by PMMA membranes was mainly due to adsorption (Fig.…”

Section: Discussionmentioning

confidence: 60%

“…PS membrane is widely used in pre-dilution OL-HDF in Japan due to its high permeability. PMMA membrane is a synthetic polymer membrane with a homogeneous symmetric structure and larger pores on the inner surface [12]. By adsorption, PMMA membranes can remove medium- to high-molecular-weight proteins, including β 2 -m [12]; therefore, OL-HDF using a PMMA hemodiafilter can be effective in removing these proteins.…”

Section: Introductionmentioning

confidence: 99%

“…PMMA membrane is a synthetic polymer membrane with a homogeneous symmetric structure and larger pores on the inner surface [12]. By adsorption, PMMA membranes can remove medium- to high-molecular-weight proteins, including β 2 -m [12]; therefore, OL-HDF using a PMMA hemodiafilter can be effective in removing these proteins. Since PMMA membranes have low permeability, post-dilution OL-HDF with the PMMA hemodiafilter may effectively remove molecules while ensuring safety.…”

Section: Introductionmentioning

confidence: 99%

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Removal of α1-Microglobulin Using Post-Dilution Online Hemodiafiltration with Polymethylmethacrylate Membrane: An Open-Label, Single-Arm Study

Yoshida,

Yamamoto,

Miyauchi

et al. 2023

Blood Purif

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Introduction: The removal of low- and medium-molecular-weight proteins has been improved with online hemodiafiltration (OL-HDF) and hemodialysis using high-flux membranes; however, the outcomes of patients with end-stage kidney disease (ESKD) undergoing dialysis treatment are still worse than in the general population. α1-Microglobulin (α1-m), with a molecular weight of 33,000 Da, may contribute to dialysis-related disorders and mortality. However, the removal is insufficient even with current OL-HDF using the polysulfone (PS) membrane, which is common in Japan. Polymethylmethacrylate (PMMA) membranes can remove medium- to high-molecular-weight proteins by adsorption. This study aimed to assess the efficacy of removing medium- to high-molecular-weight proteins, such as α1-m and β2-microglobulin (β2-m), through post-dilution OL-HDF with PMMA (Post-PMMA). The assessment was conducted in comparison to pre-dilution OL-HDF with PS (Pre-PS), using an open-label, single-arm study. Methods: Seven patients with ESKD on Pre-PS underwent Post-PMMA with replacement volume of 30 mL/min (low flow) and 50 mL/min (high flow). Clearance and removal rates of α1-m, β2-m, small molecules, inflammatory cytokines, and albumin were measured at 60 and 240 min of treatment. Results: Clearance rates of α1-m at 60 min were −2.8 ± 5.2 mL/min with Pre-PS, −0.4 ± 2.6 mL/min with Post-PMMA (low), and 0.6 ± 3.4 mL/min with Post-PMMA (high). The removal rate of α1-m was higher in Post-PMMA than that in Pre-HDF-PS (Post-PMMA [high] 17.7 ± 5.9%, Post-PMMA [low] 15.0 ± 5.6%, and Pre-PS 4.1 ± 5.5%). Adsorption clearance of β2-m was increased with Post-PMMA. Albumin leakage in Post-PMMA was not higher than that in Pre-PS. Conclusion: The removal rate of α1-m with Post-PMMA was higher than that with Pre-PS. The PMMA membrane adsorbed β2-m, suggesting the removal effect of medium- to high-molecular-weight proteins by the adsorption method. Since Post-PMMA effectively removes α1-m without excessive albumin leakage, it will be useful for patients with ESKD, especially those with a poor nutritional status.

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Section: Discussionmentioning

confidence: 60%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Removal of α1-Microglobulin Using Post-Dilution Online Hemodiafiltration with Polymethylmethacrylate Membrane: An Open-Label, Single-Arm Study

Yoshida,

Yamamoto,

Miyauchi

et al. 2023

Blood Purif

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“…Filtryzer s , a hemodialyzer that uses PMMA membrane, was approved in Japan in 1977 and has been in use worldwide for more than 40 years. 50 Many synthetic polymeric hollow fiber membranes, including PSf and PES, have an asymmetric structure which have a thin skin layer with very small pore sizes controlling solute separation. The PMMA membrane has a homogeneous structure with a uniform pore size, and solute separation is controlled by the whole membrane.…”

Section: The Isopropyl Groups In Psf Dialysis Membranes Can Generatementioning

confidence: 99%

The separation membranes in artificial organs

Sheng

Sun

et al. 2023

Mater. Chem. Front.

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“…The average of adsorption to diffusion and convection, featuring PMMA membranes, allows the removal of various proteins including middle- and large-molecular weight ones. In vitro evaluation of protein removal by PMMA membranes indicated that the removal rates for proteins larger than IL-6 were higher than those removed by polysulfone membranes [ 116 ]. The adsorption observed in PMMA seems to be due to the occlusion of protein molecules into the pores of the membrane [ 117 ].…”

Section: Adsorptive Dialysis Membranes and Modulation Of The Cd40-cd4...mentioning

confidence: 99%

Role of the CD40-CD40 Ligand Pathway in Cardiovascular Events, Neurological Alterations, and Other Clinical Complications of Chronic Hemodialysis Patients: Protective Role of Adsorptive Membranes

Marengo¹,

Migliori

Merlotti

et al. 2023

Blood Purif

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Despite the recent advances in dialysis technology, mortality rate of chronic uremic patients still remains excessively high: of note, in comparison to age- and sex-matched healthy controls, this frail population shows a higher incidence of infections, cancer, cognitive decline, and, in particular, major adverse cardiovascular events (MACE) that represent nowadays the first cause of mortality. Several traditional and nontraditional factors contribute to this increased risk for MACE and accelerated cellular senescence: among these, inflammation has been shown to play a key role. The costimulatory pathway CD40-CD40 Ligand (CD40L) is harmfully activated during inflammation and uremia-associated clinical complications: in particular, the soluble form of CD40L (sCD40L) can bind to the CD40 receptor triggering a cascade of detrimental pathways in immune and nonimmune cells. In this narrative review, we summarize the current concepts of the biological role of the CD40-CD40L pathway in uremia-associated organ dysfunction, focusing on the above-described main causes of mortality. Moreover, we discuss the interaction of the CD40-CD40L pathway with extracellular vesicles, microparticles recently identified as new uremic toxins. The biological effects of sCD40L in MACE, cognitive decline, infections, and cancer will be also briefly commented. Last, based on recent studies and ongoing clinical trials, we herein describe the modulatory activity of adsorptive dialysis membranes in polymethylmethacrylate on CD40-CD40L detrimental activation.

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Polymethylmethacrylate Membrane Dialyzer: Historic but Modern

Cited by 4 publications

References 32 publications

Removal of α<sub>1</sub>-Microglobulin Using Post-Dilution Online Hemodiafiltration with Polymethylmethacrylate Membrane: An Open-Label, Single-Arm Study

Removal of α<sub>1</sub>-Microglobulin Using Post-Dilution Online Hemodiafiltration with Polymethylmethacrylate Membrane: An Open-Label, Single-Arm Study

The separation membranes in artificial organs

Role of the CD40-CD40 Ligand Pathway in Cardiovascular Events, Neurological Alterations, and Other Clinical Complications of Chronic Hemodialysis Patients: Protective Role of Adsorptive Membranes

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