Dialysis Seminar, September 20

Paul Lowe has been working on technical aspects of Dialysis for more years than he cares to remember. Paul is a Senior Electronics Technician working in Beaumont Hospital.

A one day seminar entitled "New Approaches in Dialysis Therapy" was held in the Davenport Hotel on September 20th. The day was hosted by PEI who hold the agency for Fresenius Dialysis products here in Ireland. The day consisted of a series of presentations in the morning and an exhibition of dialysis equipment marketed by Fresenius in the afternoon.

There were four presentations in the morning which were as follows:

1. Development of Water Treatment Technology for Haemodialysis.
2. Dialysers and today's selection criteria.
3. Does the choice of dialyser have a clinical impact?
4. On-line Hemodialfiltration technical and clinical aspects.

The first presentation on water treatment was presented by Mr Evans, marketing manager with DWA a subsidiary of Elga water treatment. A summary of developments in water treatment for use in Haemodialysis over the past 20 years was presented. Information was given on current trends in water treatment dealing with developments in Reverse Osmosis technology and current thinking on distribution systems for dialysis. The speaker did not delve deeply into technical aspects of water treatment since the audience was composed predominantly of medical personnel. At this level, however, the lecture was informative and educational for relevant personnel.

The following two lectures presented by Dr Vischer and Dr Brown both from Fresenius were similar in content. Both presentations compared the use of Polysulphone high flux dialysers to the iraditional Cuprophane and Cellulose Acetate dialysers. The comparison was made in terms of biocompatability and middle molecule clearance. Both presentations showed the Polysulphone high flux dialyser to be more effective than its low flux competitors. Perhaps a more interesting comparison would be to compare the Polysulphone membrane to high flux rivals like the AN69 membrane or Polyamide membranes. Methods of sterilisation of dialysis membranes were briefly summarised with a comparison of three methods currently in use: steam sterilisation, ethylene oxide and gamma radiation.

The final lecture presented by Dr Roy of Fresenius dealt with technical and clinical aspects of Hemodialfiltration. This was an excellent lecture although somewhat curtailed due to time constraints. Dr Roy gave the basic background to the principals of Hemodialfiltration and reasons why it is a better form of treatment than conventional haemodialysis. He also explained Fresenius methodology in assuring quality of the disposable components and the reasons for the company choosing this route for validating its components. He also explained briefly how Fresenius have developed a blood temperature monitor that allows intra-dialytic body temperature to be stabilised within tight limits. This will help Hemodynamic stability during dialysis as well as providing a method of measuring blood recirculation at the patient's access.

In conclusion, this was an interesting and worthwhile meeting which not only presented useful information but also provided a forum for those working in all aspects of Haemodialysis to meet and exchange ideas.