Nephrology Dialysis Transplantation, Vol 13, Issue 7 1752-1758, Copyright © 1998 by Oxford University Press
A Dhondt, R Vanhoder, M Waterloos, G Glorieux, R De Smet and N Lameire
Background: Citrate, used for the anticoagulation of
the extracorporeal dialysis circuit, reduces ionized calcium by chelation
and has been claimed to attenuate dialyser membrane bioincompatibility.
Dialysis with complement-activating cuprophane membranes is associated with
leukopenia which has been related to an increase in adhesion molecule
expression on the surface of circulating leukocytes.
Methods: The effect of citrate anticoagulation on the
expression of CD11b, CD11c and CD45 on the surface of granulocytes and CD14
on monocytes during haemodialysis with cuprophane membranes, was evaluated
by flow cytometric analysis. A comparison of standard heparin
vs citrate was performed in 14 chronic haemodialysis
patients. During citrate anticoagulation a calcium-free dialysate was used
and citrate was infused to obtain a concentration of 4.3 mmol/l blood. The
unchallenged 'baseline state' expression of the surface molecule and the
increase after ex vivo stimulation with phorbol
12-myristate 13-acetate (delta-PMA) or
formyl-methionyl-leucyl-phenylalanine (delta-fMLP) was studied.
Results: With heparin, as well as with citrate, a
sharp fall in granulocyte and monocyte count was observed after 15 min of
dialysis, followed by a recovery at the end of the session. The expression
of CD11b, CD11c ad CD45 on granulocytes increased markedly during
cuprophane dialysis with a peak at 15 min; there were no differences in
response between heparin and citrate anticoagulation. Delta-PMA and
delta-fMLP for CD45, CD11c and CD14 showed a decrease during cuprophane
dialysis vs t0; again there were no differences
between heparin and citrate. Conclusion: We conclude
that the use of citrate was not associated with reduced leukocyte
activation as measured by the expression of surface molecules during
cuprophane dialysis and that no effect on dialysis leukocytopenia could be
registered. Key words: adhesion molecule;
biocompatibility; calcium; citrate; cuprophane; haemodialysis
ORIGINAL ARTICLES
Citrate anticoagulation does not correct cuprophane bioincompatibility as evaluated by the expression of leukocyte surface molecules
Department of Internal Medicine, Renal Division, University Hospital, De Pintelaan 185, B-9000 Gent, Belgium; Corresponding author
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  J. Kozik-Jaromin, V. Nier, U. Heemann, B. Kreymann, and J. Bohler Citrate pharmacokinetics and calcium levels during high-flux dialysis with regional citrate anticoagulation Nephrol. Dial. Transplant., July 1, 2009; 24(7): 2244 - 2251. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. De Smet, J. Van Kaer, H. Liebich, G. Lesaffer, A. Verstraete, A. Dhondt, P. Duym, N. Lameire, and R. Vanholder Heparin-induced Release of Protein-bound Solutes during Hemodialysis Is an in Vitro Artifact Clin. Chem., May 1, 2001; 47(5): 901 - 909. [Abstract] [Full Text] [PDF]
|
|