Assuntos
Diabetes Mellitus Tipo 1/tratamento farmacológico , Nefropatias Diabéticas/tratamento farmacológico , Sistemas de Infusão de Insulina , Adolescente , Adulto , Diabetes Mellitus Tipo 1/metabolismo , Nefropatias Diabéticas/metabolismo , Feminino , Hemoglobinas Glicadas/metabolismo , Humanos , Hipertensão/fisiopatologia , Hipoglicemia/etiologia , Injeções Intraperitoneais/instrumentação , Sistemas de Infusão de Insulina/efeitos adversos , Falência Renal Crônica/etiologia , Masculino , Pessoa de Meia-Idade , Peritonite/etiologiaRESUMO
Control of ultrafiltration with high-flux dialysis membranes is normally achieved using complex, expensive, volumetric control methods. By using high-flux dialyzers with distensible membranes (parallel-plate dialyzers) in the cocurrent rather than in the countercurrent mode, ultrafiltration can be controlled simply and inexpensively by controlling the outlet pressure differential. Since this is the traditional method of ultrafiltration control, only minor, inexpensive equipment modifications are needed. As expected from transport theory, small molecule clearances are lower with cocurrent than with countercurrent flow. They are, however, adequate and superior to those achieved with post-dilutional hemofiltration (urea clearance greater than 110 ml/min with cocurrent single-pass, high-flux dialysis). Ultrafiltration control with this method is so simple and predictable that clearances at zero net ultrafiltration rates can easily be measured rather than extrapolated. Since dialysate pressure is always positive, no deaeration systems would be needed in dialysis equipment designed for use with cocurrent single-pass, high-flux dialysis.