Solute clearance by molecular weight in dialysis
Core concept
- Dialysis clearance depends on solute molecular weight and the transport mechanism used
- Diffusion (haemodialysis) - efficient for small solutes (urea ~60 Da, creatinine, potassium), clearance falls steeply as MW rises
- Convection (haemofiltration/CVVH) - clearance driven by solvent drag, far less MW-dependent -> better for middle molecules (beta-2-microglobulin ~11.8 kDa, cytokines, myoglobin)
- High-flux/high cut-off membranes + convection (haemodiafiltration) combine both for best middle-molecule clearance
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