On the kinetics of complement activation, leucopenia and granulocyte-elastase release induced by haemodialysis.
In order to elucidate the kinetics of haemodialysis-induced activation of complement, leucopenia and release of granulocyte-elastase, 10 patients (three females and seven males; mean age 47.8 years) were extensively studied during a 4 h haemodialysis treatment and for the following 24 h, and further compared with a healthy control group. Prior to dialysis patients had normal leucocyte count, plasma elastase bound to alpha 1-proteinase inhibitor (E-alpha 1P1) and total haemolytic complement, whereas plasma C3d was higher and plasma C5a lower than in controls. Haemodialysis induced initial leucopenia and subsequent rebound phenomenon lasting 24 h post treatment. These alterations were due to almost selective changes in neutrophile count as monocyte and lymphocyte counts, apart from decrease in the first 30 min, were unchanged. Total haemolytic complement decreased initially during dialysis and rose at the end. Generation of C5a within the dialyser was evident by demonstration of high levels of this anaphylatoxin in dialyser effluent plasma; maximal values observed coincided with the nadir of leukopenia. Plasma C3d and E-alpha 1P1 both progressively rose during dialysis. After termination of extracorporeal circulation the disappearance rates (T/2) were approximately 6 h and 2.5 h respectively. Haemodialysis thus induces changes in the complement and leucocyte system resembling an acute inflammation, which out-lasts the treatment period.
D000328:Adult; D001798:Blood Proteins / Q000378:metabolism; D003167:Complement Activation; D003176:Complement C3 / Q000032:analysis; D015933:Complement C3d; D003182:Complement C5 / Q000032:analysis; D015936:Complement C5a; D005260:Female; D006098:Granulocytes / Q000201:enzymology*; D006801:Humans; D007700:Kinetics; D007958:Leukocyte Count; D007970:Leukopenia / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010196:Pancreatic Elastase / Q000097:blood*; D006435:Renal Dialysis / Q000009:adverse effects*; D014511:Uremia / Q000628:therapy; D000515:alpha 1-Antitrypsin
D001798:Blood Proteins; D003176:Complement C3; D003182:Complement C5; D000515:alpha 1-Antitrypsin; D015933:Complement C3d; D015936:Complement C5a; D010196:Pancreatic Elastase