Selection guidelines for high-performance membrane.

The fundamental concept for the selection of high-performance membrane is based on solute removal capability and biocompatibility. From this principle, the selection guidelines for high-performance membrane are recommended as follows: (1) The currently available products do not provide coverage of the necessary 'balance between solute removal and biocompatibility' in a single dialyzer for all the dialysis patients. Therefore, it is advisable to choose a high-performance membrane taking into consideration the balance between the solute removal capacity necessary for the patient and the severity of complications that is considered a surrogate marker for biocompatibility. (2) There is an increasing demand in dialysis therapy for new biocompatibility indices such as 'reducing blood pressure variability during dialysis', 'decreasing oxidative stress' and 'delaying the onset or progression of complications'. High-performance membranes developed to address these needs include the ethylene-co-vinyl alcohol copolymer (EVAL) (R) membrane, cellulose triacetate, polymethylmethacrylate, vitamin E-coated polysulfone (PS) membrane, and PS membrane hemodiafiltration filter.