Alternate repetition of short fore- and backfiltrations reduces convective albumin loss

Toru Shinzato, Masamiki Miwa, Shigeru Nakai, Ichiro Takai, Yoshihiro Matsumoto, Hiroyuki Morita, Toshio Miyata, Kenji Maeda

Research output: Contribution to journalArticlepeer-review

27 Citations (Scopus)


An effective therapeutic means to remove relatively large polypeptide uremic toxins stems to be a hemofiltration (HF) or hemodiafiltration (HDF) employing a larger-pore membrane, that is, a protein-permeable membrane. With either method, however, a significant amount of albumin will be lost into the ultrafiltrate or dialysate. Now, repetition of alternate short fore- and backfiltrations may prevent the development of the ultrafiltration-induced higher albumin concentration on the membrane surface (protein concentration polarization), where a single forefiltration time is shorter than the time needed for completion of protein concentration polarization. Since the albumin concentration on the protein-permeable membrane surface will be one of the determinants of albumin loss by convection, such HDF treatment may reduce protein loss into the dialysate. To examine this assumption, we alternately repeated short and rapid fore- and backfiltrations (push/pull HDF) through a protein-permeable membrane, each less than 1 second in duration and at each filtration volume of 15 ml, where a pyrogen-free dialysate was supplied. The present results indicated that the albumin amount lost by push/pull HDF was approximately one-third of that by conventional HDF. Nevertheless, the reduction rates of β2- microglobulin and myoglobin were significantly greater by push/pull HDF than by conventional HDF.

Original languageEnglish
Pages (from-to)432-435
Number of pages4
JournalKidney International
Issue number2
Publication statusPublished - 1996
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Nephrology


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