Evidence for internal filtration in the Genius (R) system, performing slow low efficient daily dialysis in the intensive care unit

Background: Since most intensive care units (ICUs) have no access to high-quality water, the Genius (R) system, using ultrapure water and high-flux dialyzers, might be used during slow low efficient daily dialysis (SLEDD). To get an idea about convective removal, internal filtration (IF) was calculated and compared to other modalities. Methods: Validated with in vivo measurements, IF was calculated for 8 h Genius (R) SLEDD and 4 h Genius (R) standard dialysis with high-flux dialyzers, and for 8 h SLEDD and 4 h both with standard dialysis machines and low-flux as well as high-flux dialyzers. Results: In Genius (R) SLEDD (FX80), IF was 2.36 I (hematocrit [Hct] 30%) and 3.37 I (Hct 40%). About the same amount of IF was found for the different dialysis modalities, except when using low-flux dialyzers, where no IF occurred. Conclusion: The Genius (R) system allows the implementation of high-flux dialysis with ultrapure dialysate, and can be run in a SLEDD mode in the ICU. Copyright (c) 2008 S. Karger AG, Basel.