HIGH-EFFICIENCY HEMOFILTRATION.

High-efficiency hemofiltration (HF) was accomplished with an axial-spiral wound membrane device using recirculation of the blood and the cleansed filtrate. The blood side mesh design, thickness, and orientation determined the amount of recirculation needed to achieve high efficiency. The total protein, hematocrit, and pH also affected the degree of efficiency. Solute clearance, particularly of larger molecules, was adversely affected by inefficient hemofiltration conditions. As a result, clinical comparisons of hemodialysis with hemofiltration should be made only with high-efficiency hemofilters. High-efficiency HF can be used as an artificial kidney with either a minimum membrane surface area or a minimum treatment time. The preclinical results showed no clotting problems, and the devices were reusable.