AN69: Evolution of the world's first high permeability membrane

Abstract

In response to a request from the French government, Rhône-Poulenc started development of a synthetic membrane for dialysis in 1969. When used for patients the new membrane, AN69, showed improved efficiency and clinical outcome. Treatment times could be reduced, peripheral neuropathy improved and patients expressed improved quality of life. This was the introduction of high-flux, volume-controlled dialysis. The polymer used for the AN69 membrane is a copolymer of acrylonitrile and sodium methallylsulfonate, specially selected for the dialysis application. Contrary to most synthetic membranes AN69 is hydrophilic, because the numerous sulfonate groups attract water and create a hydrogel structure which provides high diffusive and hydraulic permeability. In the AN69 membrane the microstructure and the chemical composition offer a unique context for bulk adsorption of low-molecular-weight proteins, the high water content of the hydrogel making the polymer chains easily accessible. The highly specific adsorptive properties - limited on the surface and favored in the membrane structure and with high specificity for basic, medium-sized proteins - distinguish AN69 from other synthetic high-flux membranes as well as from other so-called adsorptive membranes in the field of dialysis. Since its creation in the early 1970s the AN69 membrane has evolved to meet the requirements and challenges of dialysis therapy. Still the basic characteristics of high permeability to fluid and to a wide range of relevant uremic retention products combined with excellent biocompatibility, whether measured by traditional or novel indicators, have remained the hallmark of the membrane. The unique adsorptive capacity has provided a base for further development. The latest version of AN69, HeprAN, has heparin grafting on the inner surface and enhanced adsorption of bacterial products on the outer surface. Modern versions of AN69 are today used in hemodialysis and contemporary modes of convective therapies for a large number of chronic as well as acute renal patients around the world.