Clinical evaluation of a new high-flux cellulose acetate membrane.
One major goal of dialysis therapy has become the removal of beta 2-microglobulin (beta 2-m). The interdialytic elimination of beta 2-m was studied using a newly developed high-flux cellulose acetate (CA) membrane. The results show that high-flux CA dialyzers offer better biocompatibility than classical Cuprophan or high-flux Cuprophan devices, with regard to leukopenia, C3a desarg generation, and elastase release from polymorphonuclear (PMN) leukocytes. Compared to high-flux CA membranes, high-flux PMMA membranes induce less C3a desarg formation but comparable leukopenia. High-flux PMMA membranes, however cause greater leukocyte stimulation than CA as demonstrated by more PMN elastase release during hemodialysis. Using high-flux CA or high-flux PMMA membranes, serum beta 2-m levels decreased 32% during dialysis. Serum beta 2-m dropped 10% with high-flux Cuprophan membranes, but remained unchanged with conventional Cuprophan dialyzers. Sieving coefficients for beta 2-microglobulin (beta 2-m) were virtually zero with classical Cuprophan and 0.66 with high-flux cellulose acetate membranes. High-flux membranes made of Cuprophan and PMMA gave coefficients of 0.25 and 0.45, respectively. This indicates the high removal capacity of the new CA-membrane for substances with high molecular weight. This high-flux CA membrane thus appears to combine a good degree of biocompatibility with a high capacity for beta 2-m removal.
Schaefer
R M
RM
Department of Medicine, University of Wuerzburg, FRG.
Huber
L
L
Gilge
U
U
Bausewein
K
K
Vienken
J
J
Heidland
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002482:Cellulose / Q000031:analogs & derivatives*; D003176:Complement C3 / Q000031:analogs & derivatives / Q000378:metabolism; D015926:Complement C3a / Q000031:analogs & derivatives*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000201:enzymology*; D007688:Kidneys, Artificial; D007958:Leukocyte Count; D008567:Membranes, Artificial; D008768:Methylmethacrylates; D008875:Middle Aged; D009504:Neutrophils / Q000201:enzymology; D010196:Pancreatic Elastase / Q000097:blood; D012709:Serum Albumin / Q000378:metabolism; D001613:beta 2-Microglobulin / Q000378:metabolism
D003176:Complement C3; D008567:Membranes, Artificial; D008768:Methylmethacrylates; D012709:Serum Albumin; D001613:beta 2-Microglobulin; C044541:complement C3a, des-Arg-(77)-; C005062:acetylcellulose; D015926:Complement C3a; D002482:Cellulose; C009865:cuprammonium cellulose; D010196:Pancreatic Elastase