title: Granulocyte elastase, beta-thromboglobulin, and C3d during acetate or bicarbonate hemodialysis with Hemophan compared to a cellulose acetate membrane.
abstract: Twenty-two patients were dialysed in a cross-over design using Hemophan or cellulose acetate membranes. The dialysate buffer was acetate (n = 12) or bicarbonate (n = 10). Blood was sampled at 0, 15, 60 and 180 min and mean values were adjusted for changes in total protein in each sample. At 15 min during dialysis a decrease in leukocytes and platelets occurred with both membranes, irrespective of the buffer (Wilcoxon, p less than 0.006). During dialysis, increases were found in granulocyte elastase inhibitor complex (E- alpha 1-PI), beta-thromboglobulin and C3d. beta 2-microglobulin was not significantly changed in blood after dialysis with Hemophan or cellulose acetate membranes with bicarbonate buffer. Side effects were more pronounced at 180 min during dialysis with bicarbonate in patients using cellulose acetate than with Hemophan (p = 0.021, n = 8). Hemophan seemed to be more favourable than cellulose acetate membranes in regard to leukopenia and E- alpha 1-PI. The dialysate buffer may also alter membrane biocompatibility.
authors.affiliation: Department of Internal Medicine, University Hospital, Umeå, Sweden.
authors.forename: B G
authors.initials: BG
authors.lastname: Stegmayr
authors.forename: K
authors.initials: K
authors.lastname: Esbensen
authors.forename: A
authors.initials: A
authors.lastname: Gutierrez
authors.forename: L
authors.initials: L
authors.lastname: Lundberg
authors.forename: B
authors.initials: B
authors.lastname: Nielsen
authors.forename: C E
authors.initials: CE
authors.lastname: Stroemsaeter
authors.forename: B
authors.initials: B
authors.lastname: Wehle
mesh_terms: D001672:Biocompatible Materials; D002021:Buffers; D002482:Cellulose / Q000031:analogs & derivatives*; D015933:Complement C3d / Q000032:analysis*; D006801:Humans; D007202:Indicators and Reagents; D007676:Kidney Failure, Chronic / Q000628:therapy; D019272:Leukocyte Elastase; D008567:Membranes, Artificial; D008875:Middle Aged; D010196:Pancreatic Elastase / Q000378:metabolism*; D006435:Renal Dialysis / Q000295:instrumentation*; D015842:Serine Proteinase Inhibitors / Q000097:blood; D015843:Serpins; D001620:beta-Thromboglobulin / Q000032:analysis*
chemical_list: D001672:Biocompatible Materials; D002021:Buffers; D007202:Indicators and Reagents; D008567:Membranes, Artificial; D015842:Serine Proteinase Inhibitors; D015843:Serpins; D001620:beta-Thromboglobulin; C054645:Hemophan; C005062:acetylcellulose; D015933:Complement C3d; D002482:Cellulose; D010196:Pancreatic Elastase; D019272:Leukocyte Elastase