Volume 26, Issue 2 pp. 152-159

Quo vadis Dialysis Membrane?

Joerg Vienken

Joerg Vienken

Fresenius Medical Care, Bad Homburg, Germany

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Sudhir Bowry

Sudhir Bowry

Fresenius Medical Care, Bad Homburg, Germany

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First published: 22 September 2008
Citations: 13
Address correspondence and reprint requests to Dr. Joerg Vienken, Fresenius Medical Care, Else Kroenerstraße 1, D-61342 Bad Homburg, Germany. E-mail: [email protected]

Abstract

Abstract: The development of dialysis membranes is closely related to the development of dialysis as a routine therapy for patients with kidney failure. Without having membranes and dialyzers available as commodity products, the treatment of more than 1 million uremic patients worldwide would be impossible. Several transition periods can be identified: a change in membrane geometry from flat sheet to capillaries, a shift in market appreciation from cellulose to synthetic polymers, and from low-flux to high-flux dialyzers. This shift is supported by the notion that convective therapies using high-flux membranes allow the removal of large-molecular-weight solutes. From a historical background, three eras of perception can be identified for both membrane and dialysis development. First, the period of survival when nephrologists had to focus on techniques for blood access and availability of membranes. Second, the period of issues dedicated to rather specific features of membranes and dialysis therapy such as dose of dialysis, reuse, sterilization, and membrane biocompatibility. And third, the period of quality tops this sequence with a complicated approach: the principal area of interest from the medical community has switched to issues such as quality of life, morbidity, mortality, therapy standards, and cost-effectiveness. New membrane developments should focus on this situation.

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