Dialyzers...which is best?

[kit78]

I just switched centers and was on 180 but at the new place they use 160 on everyone.  Does anyone know if it truly matters with these as to which one is used or should I be concerned.  I felt better when I came off as opposed to other center.  Hand felt better too, which has been an ongoing issue.  Thanks.

[noahvale]

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[kit78]

That didn't answer my question other than to each their own theory.  Centers won't pay for the top one. One center uses all 180's...this new one uses 160's.  Just want to know the difference.

[obsidianom]

Dialyzer size and efficiency[edit source]
 
Dialyzers come in many different sizes. A larger dialyzer with a larger membrane area (A) will usually remove more solutes than a smaller dialyzer, especially at high blood flow rates. This also depends on the membrane permeability coefficient K0 for the solute in question. So dialyzer efficiency is usually expressed as the K0A - the product of permeability coefficient and area. Most dialyzers have membrane surface areas of 0.8 to 2.2 square meters, and values of K0A ranging from about 500 to 1500 mL/min. K0A, expressed in mL/min, can be thought of as the maximum clearance of a dialyzer at very high blood and dialysate flow rates

Bigger dialyzeer= more solutes dialyzed

[kit78]

OK...so in layman terms,  it's not hurting me much stepping down one size.  I'll ask my neph and if needed he can make them get the 180's but I think they may be why I feel better and hand feels much better as well.

[Simon Dog]

That didn't answer my question other than to each their own theory.  Centers won't pay for the top one. One center uses all 180's...this new one uses 160's.  Just want to know the difference.

I recently field a complaint with an FMC facility that had a "160's only for visiting patients".   I was very impressed by their follow-up - they investigated, considered my input, and responded by rescinding that policy.   As part of the follow-up, I was informed the the cost difference between a 160 and 180 filter is about 50 cents.

The 180 has 1.8 square meters of surface the 160 has 1.5 (not 1.6).  The larger filter is more efficient and you will get slightly higher clearance.

My doc advised that he has to get approval from the P&T committee before using a 200 (or presumably 250) filter.  Curiously, the federal dialysis clinic at Devans (the federal prison) has standardized on 250s.

[noahvale]

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[Simon Dog]

Read about the different dialyzers here: http://www.fmcna-dialyzers.com/

[frankswife]

Frank's neph said his blood was not being cleaned well enough so he went from a 200 to a 250. Is that the biggest?

[Simon Dog]

Frank's neph said his blood was not being cleaned well enough so he went from a 200 to a 250. Is that the biggest?

Yup (at least form the FMC catalog), though you can string multiple dialyzers in series in extreme cases.

[kit78]

See now last week my doc said I was getting excellent clearance and put me from 4 hrs. to 3.45 hrs.  I still feel the same, but at 50 cents heck if I see a change I will have my neph. get me the better ones.

[noahvale]

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