Cellulose triacetate: another membrane for continuous renal replacement therapy

The evolution of technology and biomaterials has permitted a parallel devel opment of renal replacement therapies in the acute, critically ill patient. From the original continuous artero-venous hemofiltration method new techn iques such as continuous veno-venous hemofiltration, hemodiafiltration and high-flux: dialysis have been developed and are clinically used. Similar pr ogress has been made with artificial membranes. We investigated the possibi lity of using a modified cellulosic membrane for continuous therapies, asse ssing the hydraulic characteristics and clearance performances of high-flux cellulose triacetate hemodiafilter (0.7 m(2)) in vitro and in vivo. The fl owdynamic characteristics of the filter suggest its optimal use in veno-ven ous pump-drive techniques. Efficiency was excellent, with urea daily cleara nces as high as 50 liters or more. The high permeability and porosity of th e membrane also increased the clearances of larger solutes such as creatini ne and inulin. No side effects occurred during treatment and we conclude th at cellulose triacetate may be considered a good alternative to synthetic m embranes in continuous renal replacement therapies.