In vivo Assessment of a Manual Single Lumen Alternating Micro-Batch Hemodiafiltration System

The manual single lumen alternating micro-batch hemodiafiltration (mSLAMB) system is a closed-loop dialysis system designed to provide kidney support in emergency situations (e.g., fluid overload, hyperkalemia, acidemia). If done repeatedly in small batches and at high flow rates, this system was fo...

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Bibliographic Details
Published in:	Blood purification Vol. 53; no. 8; p. 650
Main Authors:	Lanker, Sabrina L, Pino, Christopher J, Humes, H David, Chawla, Lakhmir, Johnston, Kimberly A
Format:	Journal Article
Language:	English
Published:	Switzerland 2024
Subjects:	Animals Hemodiafiltration - instrumentation Hemodiafiltration - methods Potassium - blood Swine SLAMB Low-income countries Manual dialysis Austere medical environment Acute kidney injury
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Summary:	The manual single lumen alternating micro-batch hemodiafiltration (mSLAMB) system is a closed-loop dialysis system designed to provide kidney support in emergency situations (e.g., fluid overload, hyperkalemia, acidemia). If done repeatedly in small batches and at high flow rates, this system was found to achieve clearance levels comparable to traditional renal replacement therapy. Using a porcine model, uremic toxins and exogenous fluorescent tracer concentrations were successfully lowered within just 1 h of treatment. With a maximal dialysate flow, mSLAMB can achieve decreases in serum potassium concentration of >0.5 mmol/L/h. With the mSLAMB hemodiafiltration system, micro-batch processing was also successful in removing up to 250 mL of ultrafiltrate in 8 cycles. This process could create a better fluid balance allowing for administering therapeutic fluids such as sodium bicarbonate in the clinic. Electrolyte imbalance and volume overload remain severe life-threatening emergencies in low resource settings; therefore, mSLAMB should be explored further due to its modest vascular access requirements, low cost, and ability to be performed without electricity or batteries.
ISSN:	1421-9735
DOI:	10.1159/000538358