Dialyzer structure and membrane biocompatibility

Abstract

The objectives of this chapter are to provide an overview of the dialyzer structure with emphasis on advances in dialyzer performance and novel design features. This is followed by an in-depth review of the various biomaterials used for dialyzer membranes, namely unsubstituted cellulose, substituted or modified cellulose and synthetic polymers, with a discussion of their physical, chemical and biological properties. Key features of biocompatibility of dialyzer membranes including activation of the complement system and coagulation cascade, and activation of platelets and leukocytes are then discussed. Emphasis is given to the clinical relevance of dialysis membrane biocompatibility and specific syndromes are highlighted including hemodialysis-induced hypoxemia, dialyzer reactions, β 2-microglobulin deposition, protein catabolism, susceptibility to infection due to immune dysfunction, and survival of patients with kidney failure. © 2013 Springer-Verlag Berlin Heidelberg.