Nephrology Dialysis Transplantation, Vol 12, Issue 5 965-972, Copyright © 1997 by Oxford University Press
R Ward, A Buscaroli, B Schmidt, S Stefoni, H Gurland and H Klinkmann
The solute removal characteristics and haemocompatibility of low-flux
dialysers containing Cuprophanm, cellulose acetate,
polymethylmethacrylate (PMMA), and polycarbonate-polyether
(Gambranem) membranes were compared in a multicentre
cross-over clinical trial. While all four dialysers provided comparable
removal of urea and creatinine, the dialyser containing PMMA membrane
showed a reduced ability to remove phosphate compared to that containing
Cuprophan membrane. Significant {beta}2-microglobulin removal was
obtained with the dialyser containing Gambrane membrane, whereas the other
three dialysers had no impact on plasma {beta}2-microglobulin
concentrations. The ability to activate complement, measured as changes in
the plasma concentrations of C3a des Arg and the terminal complement
complex, and to produce leukopenia was greater for the dialyser containing
Cuprophan membrane than for the other three. The ability to activate
complement and cause leukopenia was not consistent among the remaining
three dialysers and the degree of leukopenia could not be predicted from
the level of complement activation. Neutrophil degranulation, as indicated
by the release of elastase-&agr;1-proteinase inhibitor, occurred to a
greater extent with the dialysers containing Cuprophan and Gambrane
membranes. None of the dialysers was overtly thrombogenic as judged by
changes in platelet count and plasma concentrations of the
thrombin-antithrombin III complex. Our results demonstrate that although
there are many similarities between dialysers containing low-flux
membranes, there are also significant differences. These differences may
enable improvements in therapy, while allowing continued use of low-flux
dialysers. Keywords: {beta}2-microglobulin;
haemocompatibility; haemodialysis; low-flux; membrane; solute removal
ORIGINAL ARTICLES
A comparison of dialysers with low-flux membranes: significant differences in spite of many similarities
Division of Nephrology, School of Medicine, University of Louisville, Louisville, KY, USA; Institute of Nephrology and Dialysis, St Orsola University Hospital, Bologna, Italy; Department of Nephrology, Klinikum Grosshadern, University of Munich, Munich, Germany; International Faculty of Artificial Organs, University of Strathclyde, Glasgow, UK; Correspondence to RA Ward, Division of Nephrology, Department of Medicine, School of Medicine, University of Louisville, Louisville, KY 40292, USA
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