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• SPAD, MARS and non-stop veno-venous haemodiafiltration (CVVHDF) had been in comparison in vitro with regard to detoxing capacity. SPAD and CVVHDF confirmed a significantly extra reduction of ammonia in comparison with MARS. No big variations may be discovered between SPAD, MARS and CVVHDF concerning different water-soluble substances. However, SPAD enabled a substantially more bilirubin discount than MARS. Bilirubin serves as an essential marker substance for albumin-bound (non-water-soluble) materials. Concerning the reduction of bile acids no enormous differences among SPAD and MARS had been visible. It turned into concluded that the detoxification capability of SPAD is similar or even higher whilst compared with the extra sophisticated, extra complicated and subsequently greater steeply-priced MARS.

• As albumin dialysis is a expensive process, economic factors are important: For a seven-hour treatment with MARS, approximately €300 for 600 ml human serum albumin solution (20%), €1740 for a MARS remedy package, and €125 for disposables used by the dialysis system must be spent. The fee of this remedy adds as much as about €2165. Performing SPAD according to the protocol with the aid of Sauer et al., but, requires a thousand ml of human albumin answer (20%) at a cost of €500. A high-flux dialyzer costing about €40 and the tubings (€125) must additionally be purchased. The overall expenses of a SPAD treatment is about €656—30% of the charges of an similarly efficient MARS remedy session. The expenditure for the MARS monitor necessary to perform the MARS disposables is not protected on this calculation.

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