Combining SPECT Medical Imaging and Computational Fluid Dynamics for Analyzing Blood and Dialysate Flow in Hemodialyzers

Performance Comparison of Alternative Hollow-Fiber Modules for Hemodialysis by Means of a CFD-Based Model

Commercial hemodialyzers are hollow-fiber cylindrical modules with dimensions and inlet–outlet configurations dictated mostly by practice. However, alternative configurations are possible, and one may ask how they would behave in terms of performance. In principle, it would be possible to depart from the standard counter-flow design, while still keeping high clearance values, thanks to the increase in the shell-side Sherwood number (Sh) due to the cross-flow. To elucidate these aspects, a previously developed computational model was used in which blood and dialysate are treated as flowing through two interpenetrating porous media. Measured Darcy permeabilities and mass transfer coefficients derived from theoretical arguments and CFD simulations conducted at unit-cell scale were used. Blood and dialysate were alternately simulated via an iterative strategy, while appropriate source terms accounted for water and solute exchanges. Several module configurations sharing the same membrane area, but differing in overall geometry and inlet–outlet arrangement, were simulated, including a commercial unit. Although the shell-side Sherwood number increased in almost all the alternative configurations (from 14 to 25 in the best case), none of them outperformed in terms of clearance the commercial one, approaching the latter (257 vs. 255 mL/min) only in the best case. These findings confirmed the effectiveness of the established commercial module design for the currently available membrane properties.

A Review of Commercial Developments and Recent Laboratory Research of Dialyzers and Membranes for Hemodialysis Application

Dialyzers have been commercially used for hemodialysis application since the 1950s, but progress in improving their efficiencies has never stopped over the decades. This article aims to provide an up-to-date review on the commercial developments and recent laboratory research of dialyzers for hemodialysis application and to discuss the technical aspects of dialyzer development, including hollow fiber membrane materials, dialyzer design, sterilization processes and flow simulation. The technical challenges of dialyzers are also highlighted in this review, which discusses the research areas that need to be prioritized to further improve the properties of dialyzers, such as flux, biocompatibility, flow distribution and urea clearance rate. We hope this review article can provide insights to researchers in developing/designing an ideal dialyzer that can bring the best hemodialysis treatment outcomes to kidney disease patients.

Computational Fluid Dynamics (CFD) Modeling and Simulation of Flow Regulatory Mechanism in Artificial Kidney Using Finite Element Method

There is an enormous need in the health welfare sector to manufacture inexpensive dialyzer membranes with minimum dialysis duration. In order to optimize the dialysis cost and time, an in-depth analysis of the effect of dialyzer design and process parameters on toxins (ranging from tiny to large size molecules) clearance rate is required. Mathematical analysis and enhanced computational power of computers can translate the transport phenomena occurring inside the dialyzer while minimizing the development cost. In this paper, the steady-state mass transport in blood and dialysate compartment and across the membrane is investigated with convection-diffusion equations and tortuous pore diffusion model (TPDM), respectively. The two-dimensional, axisymmetric CFD model was simulated by using a solver based on the finite element method (COMSOL Multiphysics 5.4). The effect of design and process parameters is analyzed by solving model equations for varying values of design and process parameters. It is found that by introducing tortuosity in the pore diffusion model, the clearance rate of small size molecules increases, but the clearance rate of large size molecules is reduced. When the fiber aspect ratio (db/L) varies from 900 to 2300, the clearance rate increases 37.71% of its initial value. The results also show that when the pore diameter increases from 10 nm to 20 nm, the clearance rate of urea and glucose also increases by 2.09% and 7.93%, respectively, with tolerated transport of albumin molecules.

Research on polyvinylidene fluoride (PVDF) hollow-fiber hemodialyzer

In this study, polyvinylidene fluoride (PVDF) hollow-fiber hemodialysis membranes were prepared by non-solvent-induced phase separation. The PVDF hollow-fiber hemodialyzers were prepared by centrifugal casting. The results showed that the PVDF membrane had better mechanical and separation properties when the membrane wall thickness was 40 μm and the N,N-dimethylacetamide in the core was 70 Vol%. Compared with commercial polysulfone hemodialysis membrane (Fresenius F60S membrane), the PVDF membrane had better mechanical property and ultrafiltration (UF) flux of pure water. The PVDF dialyzer's removal efficiency for middle molecules was proven to be much higher than that of the F60S dialyzer. The UF coefficient of a high-flux PVDF dialyzer is 62.6 ml/h/mm Hg, whereas F60S is 42.5 ml/h/mm Hg, which can promote clearance for middle molecules.

Effect of fiber structure on dialysate flow profile and hollow-fiber hemodialyzer reliability: CT perfusion study

BACKGROUND

Uniform dialysate distributions in hollow-fiber hemodialyzers facilitate effective solute removal, and the fiber structure inside hemodialyzers plays a significant role in determining dialysate flow distribution and dialysis efficiency. The authors analyzed the effects of undulated fibers on dialysate flow profiles and hemodialyzer reliability using a perfusion CT technique.

METHOD

Using a multi-detector row CT unit, perfusion studies were performed on two different types of hemodialyzers: (A) straight fiber configuration; (B) undulated fiber configuration (wavy-shaped fibers). Deconvolution theory was used for image processing to derive dialysate flows, dialysate volumes, and mean transit time distributions. Three-dimensional perfusion maps for the two types of hemodialyzers were reconstructed using high resolution images and these parameters were compared at hemodialyzer midsections.

RESULTS

Dialysate maldistributions were observed in both types of hemodialyzer. However, dialysate flow distributions were more uniform in the undulated-fiber hemodialyzer, whereas more complex flow distributions developed in straight-fiber hemodialyzer. Reliability as determined using intraclass correlation coefficients was markedly higher for the hemodialyzer containing undulated fiber (0.968 vs. 0.496 for type A and type B, respectively).

CONCLUSIONS

The undulated-fiber type was found to have more uniform, consistent dialysate flow profiles. It is believed that this type of hemodialyzer will be found helpful for measurement and prescription of the delivered hemodialysis dose due to its better consistency.

Optimisation of solute transport in dialysers using a three-dimensional finite volume model

Dialyser manufacturers only provide limited information about mass removal under well-defined flow and solute conditions in commercially available dialysers for hemodialysis. This computational study aimed at assessing the solute transport efficiency in a dialyser for different geometries (fiber lengths and diameters). A three-dimensional finite volume model of a single fiber in a high flux polysulphone dialyser (Fresenius F60) was developed. Different equations describe blood and dialysate flow (Navier-Stokes), radial filtration flow (Darcy) and solute transport (convection-diffusion). Fluid and membrane properties were derived from in vitro and in vivo tests as well as from literature data. Urea (MW60) was used as marker to simulate small molecule removal, while middle molecule transport was modelled using vitamin B12 (MW1355) and inulin (MW5200). Keeping the fluid velocity in a single fiber constant, fiber diameter and length were changed in a wide range for evaluation of solute removal efficiency. Clearances were found enhanced by 13% (urea), 50% (vitamin B12) and 89% (inulin) for a fiber twice as long as a standard one and by 5.5% (vitamin B12) and 21% (inulin) for a fiber diameter of 150 mum instead of 200 mum. The impact of fiber dimensions was more pronounced for the middle molecules compared to urea.