Selecting a Dialyzer: Technical and Clinical Considerations

A semipermeable membrane is the basis for solute and water removal through different mechanisms, namely, diffusion, convection, adsorption, and ultrafiltration, during hemodialysis. Advances in biomaterials and improved fiber production have led to the recent development of new classes of membranes, including those aiming to approximate the permeability properties of the native kidney more closely. In this chapter, the characteristics of dialyzers (membrane + housing) used in clinical practice are discussed, with particular attention paid to the parameters that most importantly influence performance. Specifically, the effect of dialyzer design on the mechanisms primarily mediating solute removal, namely, diffusion and convection, is highlighted. The chapter includes information about newer and emerging applications, with emphasis on therapies designed to remove large molecular weight uremic toxins.