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Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
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Intermittent Hemodialysis (IHD) and Continuous Renal Replacement Therapy (CRRT) are cornerstone treatments for renal failure. Their core consumables—dialyzers and filters—exhibit fundamental engineering disparities driven by distinct clinical demands. This study systematically analyzes differences across membrane functionalization, treatment mode compatibility, and fluid dynamics to elucidate their clinical implications.
A comparative analysis was conducted across three dimensions:
1. Membrane Functionalization: Evaluation of surface modification strategies for enhanced biocompatibility and adsorptive clearance.
2. Treatment Mode Compatibility: Assessment of design adaptations enabling multi-modal support and pediatric applications.
3. Fluid Dynamics: Analysis of geometric parameters optimized for respective operational conditions.
Key findings: Our analysis reveals fundamental engineering differences driven by clinical requirements. CRRT filters are optimized for continuous, multimodal critical care with enhanced biocompatibility, while IHD dialyzers prioritize high-efficiency clearance in short sessions. The specific clinical scenarios and engineering requirements are detailed in Table 1, while the core design characteristics and functional capabilities are compared in Table 2.
Table 1: Clinical Scenarios and Engineering Requirements
Characteristic
CRRT
IHD
Treatment unit and patient
Critically ill patient with intensive care
Maintenance hemodialysis patients in the dialysis unit
Blood flow
150-250 mL/min
200-300 mL/min
Dialysis/Replacement Fluid Flow
25–30 ml/min
300–1000 ml/min
Dialysis/replacement fluid supply method
Premixed Ready-To-Use(RTU) fluids
Online preparation
Accuracy of fluid balance
+++++
+++
Clear solute characteristics
Diffusion, convection and adsorption
Diffusion and convection
Patient(Biocompatibility requirement)
High
Average
Main anticoagulation methods
Regional citrate anticoagulation (RCA)
Systemic heparin anticoagulation
Safety monitoring system
Trend warning of transmembrane pressure (TMP) and/or pressure drop, graded alarm strategy to prioritize ensuring treatment continuity
Basic pressure monitoring and acute safety response
Table 2: Design and Functional Comparison
CRRT filter
IHD dialyzer
Core Membrane Functionalization
Surface modification strategies (e.g., heparin grafting) for enhanced biocompatibility, anticoagulation, and adsorptive clearance of cytokines/endotoxins
Relatively single mode clearance based on diffusion/convection dynamics
Treatment mode
Multiple modes of CVVH, CVVHD, CVVHDF, and SCUF
Fixed HD or HDF mode with selected dialyzer
Membrane pore size range
3-10 nm（Wide distribution considering small and medium-sized molecules）
2-5 nm（Fixed classification, such as LF, HF, etc）
Membrane area
0.2 - 1.5 m2
1.2-2.2 m2
Treatment duration
24-72 hours continuous
3-4 hours/time
Shear stress adaptability
Low shear optimization (blood flow 100-200 mL/min)
High shear design (blood flow rate of 200-500 mL/min)
Children's applications
Filters cover the entire age range from adults to newborns
Mainly used for adults
Specifically: CRRT Filters demonstrate larger fiber diameter, thicker walls, and surface functionalization for cytokine adsorption, enabling prolonged, stable therapy, while IHD Dialyzers feature larger membrane area and high shear tolerance for rapid solute clearance; their fluid Dynamics optimization differs fundamentally: CRRT compensates for low-flow limitations, while IHD maximizes high-flow efficiency.
The engineering disparities between IHD dialyzers and CRRT filters are clinically driven: IHD prioritizes efficiency for stable patients, while CRRT emphasizes stability and adaptability for critical care. CRRT design extends utility beyond renal support to sepsis/MODS management.
Critical Implications: IHD dialyzers are unsuitable for CRRT due to incompatible fluid dynamics and clotting risks. Future work should quantify how these engineering differences impact patient outcomes.
Preliminary data from this analysis were previously submitted for consideration to the 2025 APAC AKI CRRT Conference.
