Evidence for internal filtration in the Genius system, performing slow low efficient daily dialysis in the intensive care unit

Background: Since most intensive care units (ICUs) have no access to high-quality water, the Genius system, using ultrapure water and high-flux dialyzers, might be used during slow low efficient daily dialysis (SLEDD). To get an idea about convective removal, internal filtration (IF) was calculated and compared to other modalities.

Methods: Validated with in vivo measurements, IF was calculated for 8 h Genius SLEDD and 4 h Genius standard dialysis with high-flux dialyzers, and for 8 h SLEDD and 4 h both with standard dialysis machines and low-flux as well as high-flux dialyzers.

Results: In Genius SLEDD (FX80), IF was 2.36 l (hematocrit [Hct] 30%) and 3.37 l (Hct 40%). About the same amount of IF was found for the different dialysis modalities, except when using low-flux dialyzers, where no IF occurred.

Conclusion: The Genius system allows the implementation of high-flux dialysis with ultrapure dialysate, and can be run in a SLEDD mode in the ICU.