appendix 1c - rexeed powerpoint · dialyzer flexible receiver coil dialysate & blood pumps mr...
TRANSCRIPT
REXEEDREXEEDAchieving a new level of comprehensive
dialyzer performance
The Features of REXEED
The new Membrane REXBRANE and new JACKETenable the best and comprehensive Performance
by Uniform Dialysate Flow Distributionwith Patient friendly Features
REXEED Concept
1. Uniform Flow Distribution of Dialysate
2. Uniform Flow Distribution of Blood
3. World first 2.5 ㎡㎡㎡㎡ Polysulfone Membrane
4. Smaller Priming Volume
5. Retained Biocompatibility Advantage
Ultimate Small MW Clearance and
Comprehensive Performance
A Combination of new Jacket and REXBRANE
gives the uniform FlowUniform Dialysate Flow Distributiongives great Clearance Performance
REXBRANE
Waved Fiber
Proprietary Biocompatibility
Small Priming Volume
The largest PS ever-2.5 m2
New JacketFull Baffle
Short Taper Structure
Totally New Jacket DesignPC Simulation-1: Effect of Full Baffle
APS REXEED
Short Taper Optimizationby Comp. Simulation
long and gradual taper
polyurethane
Baffle panel partially surrounding bundle
short & sharp taper
polyurethane
Baffle panel wholly surrounding bundle
Straight Bigger
Header
Uniform Dialysate DistributionUniform Dialysate Distribution
DialysateDialysate
Homogenenousdialysate distribution
DialysateDialysate
Uneven dialysate distribution
Impact of Dialysate Flow Distribution on Blood Return (Image)
Un-uniform PressureUniform Pressure
Ideal Pressure Image inside of Jacket
Pressure Distribution
Blood Side P1≒P2
Dialysate P3≒P4
Dialysate
Housing
P1 P2
P3 P4
Fiber
Demonstration of Dialysate Uniform Flow<Dye Analysis>>>>
Fractionated by each ca. 10ml
QD=500ml/min
IncubatorBPB sol.
Each fraction was analyzed for BPB Absorbance
0.00
0.05
0.10
0.15
0.20
0.25
0.30
0.35
0.40
0 10 20 30 40 50
Number of exhaust fractions (-)
Abs.(-)590nm
REXEED-15A(199.6)
OPTIFLUX 200NR (199.2)
Polyflux-21R(191.0)
Demonstration of DialysateUniform Flow
REXEED-15
○○○○ Ideal
×××× Broad
×××× Tailing
「「「「Time Course of Absorbance of Dye」」」」
Qb=200mL, QD=500mL/min
Others
Dialyzer
Flexible receiver coil
Dialysate & Blood pumps
MR Imager
receiver coil
dG-DTPA:
Contrast Agent
Wooden Support frame
Proof of Good Flow Distribution-2
- Visualization of Dialysate Flow by MRI -
2005
ASN
◎◎◎◎ Quick and complete Penetration X No Dialysate Penetration
REXEED-15 FX80
FC1 HTrReXeed
Qb=200/Qd=500 ml/min
Average Speed of Dialysate Flow
In MRI
FPX-180
Qb=200/Qd=500 ml/min
0
5
10
15
20
25
30
35
40
45
50
-20 -15 -10 -5 0 5 10 15 20
Radius (mm)
Sp
eed
(m
m/s
)
Sagittal
2005 ASN TH-PO629
Radius (mm)
0
5
10
15
20
25
30
35
40
45
50
-20 -15 -10 -5 0 5 10 15 20
Sp
eed
(m
m/s
)
Sagittal
REXEED Concept
1. Uniform Flow Distribution of Dialysate
2. Uniform Flow Distribution of Blood
3. World first 2.5 ㎡㎡㎡㎡ Polysulfone Membrane
4. Smaller Priming Volume
5. Retained Biocompatibility Advantage
Ultimate Small MW Clearance and
Total Performance
Ultimate Small MW Clearance and
Comprehensive Performance
Waved Fibers
JA Nagano Koseiren Shinonoi General Hospital
The 20th Congress for High Performance Membrane, ‘05
Waved Fibers make the most of Polysulfone Membrane
REXBRANE: A New Waved FiberDesigned to maximize the Performance
in conjunction with new Jacket Structure
APS-S:Straight Φ200μm
REXEED-A:Waved
Φ185μm
Fresenius FX
Fresenius Optiflux
Fresenius F-HPS PS-UW
Polyflux 21RPolyflux 21RPolyflux 21RPolyflux 21R
Expectation
1. Uniform Blood Return
2. Less residual Blood
3. Higher SM Clearance
4. Uniform Performance
Conventional REXEED
Uniform Pressure Balance Imagefor Blood and Dialysate
REXEED Concept
1. Uniform Flow Distribution of Dialysate
2. Uniform Flow Distribution of Blood
3. World first 2.5 ㎡㎡㎡㎡ Polysulfone Membrane
4. Smaller Priming Volume
5. Retained Biocompatibility Advantage
Ultimate Small MW Clearance and
Total Performance
Ultimate Small MW Clearance and
Comprehensive Performance
In Vitro Performance of REXEEDIn Vitro Performance of REXEED--2525and other Dialyzersand other Dialyzers
REXEED-25
Optiflux 200NR
EXELTRA-210 Plus
ββββ2MG Clearance (mL/min)
Urea Clearance(mL/min)
Alb S.C. 0.010
50
125
0.033330000
0.020
400
350
375
100
75
(in vitro, bovine plasma, Qb=400mL/min. Qd=800mL/min. Qf=17, 20, 25mL/min)
REXEED-S PERFORMANCEmanufacturer’s published data
UREA CLEARANCE
260
265
270
275
280
285
290
REXE
ED 2
5SRE
XEED
21S
Polyflu
x 21
0HRE
XEED
18S
Opt
iflux
F20
0NR
Opt
iflux
F18
0NR
REXE
ED 1
5SPo
lyflu
x 17
0HOpt
iflux
F16
0NR
Polyflu
x 14
0H
Flow Rates Qb 300/Qd 500 (mL/min)
Clearance (mL/min)
REXEED-A Concept
1. Uniform Flow Distribution of Dialysate
2. Uniform Flow Distribution of Blood
3. World first 2.5 ㎡㎡㎡㎡ Polysulfone Membrane
4. Smaller Priming Volume
5. Retained Biocompatibility Advantage
Ultimate Small MW Clearance and
Total Performance
Ultimate Small MW Clearance and
Comprehensive Performance
Priming Volumes
unit::::mmmm
llll
1. Less Priming Volume with same Surface Area
2. Larger Surface Area with NO Priming Volume Increase
81-90
91-100
101-110
111-120
121-130
130<
1.5 1.6 1.7 1.8 1.9 2.0 2.1 2.4 2.5
REXEED 82 95 112 128
Optiflux-NR 83 112
Polyflux-R 121 152 165
Polyflux-H 115 125
Exeltra 95 105 115
REXEED-A Concept
1. Uniform Flow Distribution of Dialysate
2. Uniform Flow Distribution of Blood
3. World first 2.5 ㎡㎡㎡㎡ Polysulfone Membrane
4. Smaller Priming Volume
5. Retained Biocompatibility Advantage
Ultimate Small MW Clearance and
Total Performance
Ultimate Small MW Clearance and
Comprehensive Performance
Excellent Biocompatibility of Asahi’s PS
W BC406080
1001201400 60 120 180 240Dialysis Duration (m in)Changed Ratio
(%) APS-15SAA社 PS膜B社 PS膜 C 3a50150250350450550
0 60 120 180 240Dialysis Duration (m in)Changed Ratio (%) APS-15SAA社 PS膜B社 PS膜WBC C3a
Technical Aspects of REXEEDTechnical Aspects of REXEED
Clinical ExperienceClinical Experience
Clinical Evaluation of Clinical Evaluation of
REXEEDREXEED--15 and PES15 and PESQb=200mL/minQd=500mL/min
0
20
40
60
80
BUN Crea UA iP β2-MG
********
0
2
4
6
****
Alb
Reduction rate (%)
Albumin loss (g/session)(11,800)
REXEED-15 PES
membrane surface area 1.5m2
Kushiro Urology Clinic
The 20th Congress for High Performance Membrane, ‘05
n=4 4hr
* P<0.05**P<0.005
Clinical Evaluation of Clinical Evaluation of
REXEEDREXEED--25 and FB25 and FB--250F250F
0
10
20
30
40
50
60
70
80
UN Crea UA IP β2-MG α1-MG
0.0
0.5
1.0
1.5
2.0
(11,800) (33,000)
Albumin
Reduction rate (%)
Kidney Center, Shirasagi Hospital
The 20th Congress for High Performance Membrane, ‘05Albumin loss (g/session)
Qb=200mL/minQd=500mL/min
REXEED-25 CTA (2.5m2)
Average weight of dialysis patients 75.8±±±±17.6Kg nnnn=8
4hrs
*** **
*** P<0.0001** P<0.01
Mean±SD
63.0
53.6
68.1
79.5
70.7
55.9
69.1
80.2
0 20 40 60 80 100
Urée
Créatinine
Phosphore
b2m
% Removal Rate
FX 60 Rexeed 15
n=10, Qb=300 Qd=500
France - Cabestany
FX 60 REXEED-15A
Minimum Heparin Requirement (Average)
Saitama School of Medicine
Complications and possible Causes to Dialyzers
REXEED will Help the Pts by
well Balanced SMW Permeability and Biocompatibility
Solute PermeabilitySolute Permeability
BiocompatibilityBiocompatibility
Dialysis-related Amyloidosis
Numbness Fatigue Hypotension
Swelling Pain Hypertension
Gout Anemia Arrhythmia
Headache Itch Coughing