The Economics Behind Dialyzers

Other changes in the market include a significant trend toward synthetic single-use dialyzers, largely driven by increasing physician focus on biocompatibility and the excellent performance profile of synthetic membranes, observed Dr. Sarah Prichard, vice president of global medical/clinical affairs and research for Baxter International’s renal business.

“When measuring performance, traditional markers such as urea continue to be extremely important, but a growing body of research suggests that larger molecules (so-called middle molecules) are also likely very important,” Prichard pointed out. “Researchers are continuing to find ways to clear middle molecules such as Beta-2 microglobulin and cystatin-c, because they are associated with dialysis-related amyloidosis and possibly other clinical complications of dialysis. Recent research also suggests that higher middle molecule clearance may lower mortality risk.

In addition, synthetic high-flux dialyzers are growing in popularity because the biocompatible nature of the membranes results in less negative impact on the patient, and they offer better clearance, she added. “An effective synthetic membrane can reduce the potential for clogging and allow molecular toxins to move more easily out of the bloodstream through the pores,” she said.

Essentially, nephrologists are looking closely at a few indicators when they choose a dialyzer that will produce the best outcome for their patients. They look at the following things, Prichard said:

• Small molecule clearance, including urea and creatinine

• Middle molecule clearance, including Beta-2, microglobulin, and cystatin-c

• Biocompatibility in a synthetic membrane

• High-flux capability

• A range of sizes to suit their patient population