[Dialysis-Control apparatus for optimization of hemodialysis procedure].

Dialysis-Control apparatus for noninvasive monitoring of hemodialysis parameters is described. The monitoring procedure is based on electrochemical measurement of the content of organic substances in salt-containing liquid. The Dialysis-Control apparatus provides timely assessment and correction of hemodialysis procedure and ensures adequacy of the delivered treatment, which leads to improvement of dialysis treatment quality.

[Use of information properties of biological liquids for correction of development of living organisms].

Liquids (in particular, water) can receive, store, and transmit different kinds of information. In our experiments, transmission of "youth and health" information from younger to older rats led to restoration of the reproductive function and improvement of health.

[Experimental rationale for possible clinical use of biodialysis].

At biodialysis, the bloods of a patient and a donor simultaneously pass through the individual mass exchangers. The cavities of the dialyzing fluid of both mass exchangers hydraulically interconnected with recurculating transport medium. The metabolites accumulating in the patient's blood pass through the membrane to the transport medium and then the second membrane to the donor's blood and they are eliminated via his/her liver and kidney. At the same time, regression occurs: the substances required for normal vital activity move from the donor's body to the patient's one. Experiments on pigs in one of which both kidneys were removed yielded clearances of major toxic metabolites by approximately 2 times less than that at routine dialysis. Daily sessions of biodialysis ensured a satisfactory state and stable levels of metabolites. At biodialysis, the state did not deteriorate. In the other series of experiments, choledochus was ligated in one of the pigs and sessions of biodialysis were initiated following 24 hours. Daily sessions could achieve stabilization of the level of bilirubin within 135 micromol/l. In the donor pig, the level of bilirubin slightly increased. Its condition remained to be satisfactory.

[Hemodialysis with biological object].

The essence of the method of biodialysis (hemodialysis with biological object) developed and suggested by the authors for clinical use consists in that the healthy organism exerts, through a system of mass transfer, a therapeutic action on the sick organism. Blood from the affected and healthy organisms is perfused through individual mass exchangers (dialyzers, hemodiafilters and hemofilters), which are hydraulically connected by a circulating transport medium. Metabolites that accumulate in blood of the affected organism diffuse into the transport medium and, from there, into blood of the healthy organism, which metabolizes them. The reverse process occurs simultaneously: substances, whose concentration in blood of the sick organism is less versus the healthy organism, diffuse from blood of the healthy organism to blood of patient. The method suggested by us can be used in clinical practice for normalizing a variety of parameters in patients with hepatic and renal insufficiency. Besides, a number of substances can be transferred from the healthy donor to patient in the process of biodialysis, which opens promising potentialities for the treatment of many diseases.

[Monitoring urea content during hemodialysis]. / Monitoring mocheviny pri gemodialize.

The urea content monitoring during hemodialysis enables the feed-back within the system "patient--artificial kidney--patient". The existing methods of determining the concentration of urea in the dialyzing solution require an expendable reagent, i.e. urease, they are discrete and need often a calibration. The electrochemical urea analyzer, worked out by the authors, is easy in use, it provides a continues information about the urea concentration and does not virtually need any calibration. Besides, the plotter, belonging to the set, provides the graphic information about the dynamic changes of urea content.

[An instrument for measuring the protein concentration in urine]. / Pribor dlia izmereniia kontsentratsii belka v moche.

The measuring of the protein concentration in urine provides for an early diagnosis of a number of diseases at the early stage of their onset. Determination of the protein concentration in urine in patients after renal transplantation made during the early postoperative period is of special diagnostic importance. The protein content in urine varies significantly during 24 hours. With urgent information on losses of the protein in urine being available, the doctor can correct, purpose-orientedly, such losses, assess the activity of the pathological process in the kidneys and evaluate the efficiency of a conducted treatment. The known methods of determining the protein concentration in biological liquids are discussed; their advantages and disadvantages are pointed out. We suggested a new method for determining the protein content in urine, which is based on changes in the electric resistance of fluid (urine) according to its protein content; the method was patented in Russia. The technique of measuring the protein concentration in urine consists in measuring the electric resistance of the examined urine before and after its filtration through a micro-pore filter, with a pore size of 2-3 nm (2-3 x 10(-9) m), intercepting the protein. There is a description of the elaborated-by-authors instrument, which is based on the mentioned technology and which cuts the time of determining the protein concentration in urine; it also makes any chemical reagents unnecessary and provides for automating the measurement process.

[Water purification for hemodialysis]. / Ochistka vody dlia gemodializa.

An electrodialysis system has been designed to purify water. It comprises two units: a preliminary preparation unit and an electrodialysis one. The system consists of columns containing zeolite, activated carbon, and ion-exchange resins. Zeolite makes water free from mechanical impurities and iron, activated carbon adsorbs organic matter and chlorine ions, ion-exchange resins soften water. The electrodialysis unit is noted for its original design. Mathematical simulation has allowed the authors to optimize the design and to make a block that makes the process continuous without repolarization, which can decant the minimum levels of salt concentrates, thus decreasing energy supply to 2 W per liter. The unit is made as a pressure filter design having the platinum-titanium electrodes and membranes MK-40 and MK-45 made in Russia. The system operates automatically. Its all components are made in Russia.

[Detoxication and disinfection by sodium hypochlorite]. / Detoksikatsiia i dezinfektsiia gipokhloritom natriia.

Sodium hypochlorite electrochemically derived from aqueous sodium chloride solutions is the most convenient and physiological source of active oxygen. It is not toxic, easily excreted, has low molecular weight, small sizes, which allows it to readily penetrate through the cellular membranes and hence can oxidize toxins that are present not only in blood, but also in tissues, which is of great clinical practical value. The high reactivity and nonspecificity of sodium hypochlorite open ample scope for its wide medical applications.

[Electrochemical regeneration of the dialyzing solution]. / Elektrokhimicheskaia regeneratsiia dializiruiushchego rastvora.

The system with electrochemical regeneration (ER) of the dialyzing solution functions as effectively as a conventional hemodialysis system: ER eliminates creatinine and potassium ions, is inferior in eliminating urea and non-organic phosphorus but superior to hemodialysis in elimination of middle-size molecular toxins. ER enables continuous purification of dialyzing solution, electrolyzer is a constant element of the regeneration system, produced by electrolyzer sodium hypochlorite warrants the system self-sterilization. ER works without systems of water purification, water communications and dialyzer concentrate that is why the procedure of detoxication can be performed outside specially equipped laboratories.

[Electrochemical regeneration of dialysis solution in experimental and clinical conditions]. / Elektrokhimicheskaia regeneratsiia dializiruiushchego rastvora v éksperimente i klinike.

The authors have created a new system for electrochemical regeneration of dialysis solution and conducted 67 experiments using a model solution. Two groups of patients with terminal renal failure were treated. The regeneration system was applied in the treatment of Group 1 patients (n = 14), the traditional acetate hemodialysis procedure was used in Group 2 (n = 11). Hemodialysis with electrochemical regeneration of dialysis fluid removed creatinine and potassium ions from critically ill patients' blood as effectively as the traditional hemodialysis procedure. During electrochemical hemodialysis, middle-molecular toxins were removed better those with the traditional one, but urea and inorganic phosphorus were eliminated slowler. Electrochemical regeneration provided continuous purification of dialysis fluid. The regenerator block can be used many times. Sodium hypochlorite ensured self-sterilization of the system. The use of electrochemical regeneration does not require water purification, water communications and dialysis concentrate, which enables the detoxification procedure to be performed outside the specially equipped rooms.

[Experimental and clinical studies of methods for regenerating the dialysis solution]. / Eksperimental'noe i klinicheskoe izuchenie metodov regeneratsii dializiruiushchego rastvora.

The efficacy of artificial kidney apparatuses was assessed by using 5 different methods of regenerating the dialysis solution. In the series of model experiments the authors have studied the quality of the solution purification from urea, creatinine, uric acid, nonorganic phosphorus and potassium ions. Clinical trial of the regeneration systems was performed in patients with chronic renal failure on preparation for renal transplantation. The efficacy of the regeneration systems by elimination from the blood of metabolic products was not inferior to the standard hemodialysis system working in the discharge mode. The most promising method was that of electrochemical regeneration of the dialysis solution.

[Hemodialysis with electrochemical regeneration of dialysis solution]. / Gemodializ s élektrokhimicheskoi regeneratsiei dializnogo rastvora.

The method of electrochemical regeneration of dialysis solution is virtually as effective as the traditional hemoperfusion system in removing creatinine and potassium ions from the body, but inferior to it as regards urea and inorganic phosphorus and superior in removal of medium-weight toxins. A more smooth reduction of urea level in the blood provides relatively stable hemodynamics in patients liable to hypotension. Electrochemical regeneration permits a continuous purification of dialysis solution, the regeneration block may be used many times, and sodium hypochlorite produced during electrolysis operation maintains the sterility of the system. Electrochemical regeneration does not require water purification systems, water communication, and dialysis concentrate, this permitting the performance of detoxication in rooms without special equipment.

[An extracorporeal blood-correcting device]. / Ekstrakorporal'noe gemokorrigiruiushchee ustroistvo

An apparatus "artificial kidney" has been constructed to improve the equipment for controlling and regulating the blood composition in the extracorporeal loop. The apparatus provides for regeneration of the dialyzing solution, ensures individual action on the blood composition, eliminates the discharge from the body of such useful substances as vitamins and amino acids and reduces the consumption of the dialyzing solution. The unit is intended for treating patients with chronic renal insufficiency.