Eeek, my antibodies are quite high, I even flush my dialyzer with extra saline. Heparin is also out of the way… :shock:
Curt, are you a tech or Doctor, hope you don’t mind…? :oops:
Could someone review biocompatible membranes?
I meant to say what are the names of some of the commonly used biocompatible membranes and what materials are they constructed from as compared to to the older models?
I think Fresenius brand is the best out there…probably the OptiFlux model…I’ve tried both the F80, F8, F7NR, F70NR, and OptiFlux and found that OptiFlux gave me minor reactions. The F70NR would give me a very bad headache…
I do believe there are other alternatives but Fresenius is the BIG BOY…cadillac of all dialyzer…in my opinion… 
Read this tip
Gus asked:
Curt, are you a tech or Doctor, hope you don’t mind…? No, not at all.
Gus, I have a background as a technician. I became involved in dialysis in 1967 when my mother started on dialysis. She dialyzed 8 hous 3 nites a week. One of my chores in high school was rebuilding the Kiil dialyzer. When I was 18 my father died in a car accident, so I became my mothers helper until she passed away in '74. I started working as a technician in '75. I worked inpatient care, machine maintenance, reuse, and home training. I was technical Manager of the hospital from '89 to '98 when the hospital sold the unit to an LDO (Large Dialysis Organization). I then went to work as an administrator for one of the other LDO’s.
I left that job in 2004 when I co-founded a new company called Home Dialysis Plus. We are developing new products for home hemodialysis, and have a bench top prototype of a new machine, as well as some new technology from Oregon State that has promise as an improvement on dialyzers. We are in the process of raising money to get the products further developed.
At this point, I work as a consultant to pay the bills, writing education material for the Network, and working with other facilities as I can find jobs. Last year I even went to a reseach facility in Berkeley and dialyzed pigs!
I have followed Home Dialysis Central since even before it was up and running (I have known Dori for a long time). I periodically check out the message boards for ideas and indirect input (we’re thinking small!). I am very impressed with the many posts and the imense knowledge that many of you have.
Thank you for letting me participate with you here.
Curt
The more bio-compatible membranes are made of synthetic or semi-synthetic materials. These include polysulphone (PS), Polyacrylanitrile (PAN), Polylmethylmethacrilate (PMMA), Cellulose Tri-Acetate (CTA), Poly Synthane, and others.
The less bio-compatible membranes are made of natural materials - cotton fibers!. These include Cuprophane, Cellulose acetate, and others.
When I was first learning about these membranes, it didn’t make sense. I feel much more comfortable wearing a cotton shirt than I do polyesther, and this analogy is not entirely inaccurate. Polyesther clothing isn’t as comfortable because it doesn’t breathe like cotton-- it doesn’t let water through.
The synthetic dialyzer fibers repel water as well, this is called hydrophobic. (Think of water on a freshly waxed car). Proteins in the blood are incapsulated in water and when it comes in contact with the membrane the water moves away so fast that the protein is left to stick on the membrane. This causes a more rapid build up of the “secondary membrane”, which isolates the blood from the dialyzer membrane. The effect of this is that the compliment activation is stopped much more quickly than with the natural cotton materials.
I read one study years ago where they put disks of material in petri dishes with blood so that there was not a flow of blood to put down a secondary membrane, and the cotton based material actually reacted less than the synthetics!
As strange as it may seem, these new dialyzers are more biocompatible because they react more strongly to blood than natural fibers. No matter how the affect the blood in the dialyzer, the net effect is that you experience less reaction inside your body, which is where it counts.
Curt
Thank you for your posts Curt. I would be very interested in hearing about what you guys at Home Dialysis Plus are working on - the vision, the challenges, the successes. Maybe start a new thread? What I’ve heard is that you guys are working on making the dialyzer more efficient - which will allow for the overall machine to get smaller. How’s it going?
The information you posted in regard to compliment activation is very interesting. As someone who plans on being on dialysis for the duration I’ve tried to learn what I can about chronic inflammation. One of the things I think Aksys does well is minimize inflammation through ultra pure dialysate and reusing the dialyzer and blood tubing set. Time will tell what all the pieces add up too; I hope I can continue to function at a high level for a long time to come.
Hey Curt, thanks for the reply and letting us patients know a little bit about you.
Am impressed with the years experience and interest you have in the dialysis community. That picture you posted above daunts me and sure looks scary how dialysis was back then.
I did read about Home Dialysis Plus and its plans and would like to be updated on its projects status. The most important part of that project for me is the goal of making a more efficient dialyzer and at the size of 6 small sugar cubes…now come on. :roll: Anyway, luck to you and the rest of the team. hope you can accomplish that goal…
Bill@ Keep you fingers crossed, hopefully after 20 years you won’t get carpal-tinnel. Perhaps even by that time there’s gonna be a better therapy option… 8)
Boy Curt, did that picture bring back memories. That was the first machine I was trained on in about 1973 when my father started dialysis. A couple of years later the Dow came out and we were retrained for that one. As I’ve said before, although the dialyzers have become smaller and more efficient, I was amazed at how little really seems to have changed in the 30+ years between my father’s dialysis and mine.
Cathy
self home hemo 9/04
PKD
Because we are early in development, and still raising capital, I cannot give many details in such a public forum.
The idea for a new machine came several years ago. When Althin moved its machine manufacturing from Portland to Miami, most of the engineers did’nt go with them. A group of them, including Dr. Drake, co-founder of Drake-Willock and I started talking about home hemo in 1998, and made some progress with some design concepts. In 2003 we jioned with the Altman-Browning Company (ABCo) and eventually formed formed HD+. The goal is to make the machine very small and very simple to operate. Though it will have a different name by the time it is on the market, it now goes by the project name “Vera”, after my mother. We have two home patients (one is now transplanted) who work with us and give us ideas.
We came across some new technology from OSU, and realized that it had potential as a dialyzer.It’s original application was not medical. Our research has shown that it can provide diffusive clearances equal to a regular dialyzer with less than half of the surface area and considerbaly less dialysate. Were are not shooting for higher clearances, because the limiting factor is the membranes inside the body. It looks at this point as though we can acheive clearances equal to or greater than a standard dialyzer in a package that is about the size of one half of a palm pilot. Experiments with blood are underway, and we will know more when they are completed.
I will let you know more about these when I can.
Bill, I would like to thank you for one of your posts, where you mentioned Jim Boag. He was a very dear friend, and it is nice to know that his contributions are still remembered. And you are correct about your machine minimizing compliment activation by eliminating exposure to endotoxin from the dialysate. Because it reuses and disinfects the dialyzer with only hot water, it should not srtip off the secondary membrane and is more biocompatible on subsequent uses because the membrane is already isolated.
Thank you,
Curt
Thanks for sharing what you can Curt, I look forward to hearing more when the time is right. The kidney is half the size of a Palm Pilot right? or the whole device? hmmm…so many questions but I understand the need for discretion.
It was Jim who opened my eyes to the technical side of dialysis. Jim was very generous sharing information on the Dialysis_Support list: Flow rates, conductivity, TMP - it really helped me to have an expert technical explanation. Jim was also the first person to encourage me in my efforts to get internet access during incenter treatments - we talked about how to get wireless access at the dialysis chair but since it was 1996 or 97 we were too far ahead of the market. I’m sure Jim would be pleased that now eight years later all NKC units have wireless internet and loaner laptops.
Bill,
Yes it is just the dialyzer that is that size!
Jim would be very pleased to hear that NKC has wirelesst in their units. I learned a lot from Jim over the years. In fact, he was the one who helped many in the dialysis community understand back filtration and how it positively effects the conductive clearance of larger molecules, and that is certainly where I learned it.
Cathy, I agree with you in how little has changed over the years, in many ways. Technology has improved safety and makes it much easier, but not improved the treatment as much as we want. Dr. Charra in France was gettin good results with his program (nocturnal) using those same Kiil dialyzers up until a few years ago.
Have a great weekend all!
Curt
Absolutley, THINK SMALL 8) The smaller the better…
If all StarBucks have wirelss, why not all dialysis clinics? Patients should be able to take their laptops and connect to the net without hassle…perhaps maybe there is not a demand for it but would be cool…
I really think alot alot has changed since the early first days of dialysis, if you look closely you’ll notice an enormous amout of changes, from community to technical and design. It may seem like nada, but the fact is yes, there has been great strides. Probably the only general thing that doesn’t change is the patient with needles in arm and connected to a dialysis machine… :roll:
I really think alot alot has changed since the early first days of dialysis, if you look closely you’ll notice an enormous amout of changes, from community to technical and design. It may seem like nada, but the fact is yes, there has been great strides. Probably the only general thing that doesn’t change is the patient with needles in arm and connected to a dialysis machine… Rolling Eyes
I think we’ll just have to agree to disagree here. I believe the technology is very much the same as it was 30 years ago, yes more safety and ease to use have been done with in inclusion of computer technology and water purifiers, but the actual “process” of dialysis is very much the same from fistulas to the method used to remove waste.
We know more about maintaining phosphorus levels etc., but considering all the changes in medicine in the last 30 years, I continue to be amazed at how little things have changed in dialysis.
bump for Jim Curtis’s explaination of amyloid