Complement activation is influenced by the membrane material, design of the dialyser, sterilizing method, and type of dialysate.
The complement system becomes activated during blood-membrane contact in the dialyser. This study was designed to evaluate to what extent the dialyser design, the sterilization method, and the type of dialysate influence complement as measured by C3d. Twelve patients were dialysed three times on each of four different dialysers. Two hollow-fibre dialysers made of cuprophane (Hf-CuE ethylene-oxide-sterilized, Hf-CuS steam-sterilized) were compared with two plate dialysers made of cuprophane (P-Cu) or polycarbonate (P-Pc). Five patients were dialysed with acetate and seven with bicarbonate. Differences in C3d between at start of dialysis and after 180 min were calculated. C3d was increased more by P-Cu than by the other dialysers (P < 0.012, n = 12). In the bicarbonate group, C3d was increased more by P-Cu than by Hf-CuS or P-Pc (P < 0.022, n = 7) and more by Hf-CuE than Hf-CuS (P = 0.013). In the acetate group, C3d was increased more by Hf-CuS and P-Cu than by P-Pc (P < 0.006, n = 5). In conclusion, complement activation during dialysis varied due to membrane material, membrane design, sterilization method, and dialysate composition.
Lundberg
L
L
Department of Internal Medicine, University Hospital, Umeå, Sweden.
Johansson
G
G
Karlsson
L
L
Stegmayr
B G
BG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003167:Complement Activation; D015933:Complement C3d / Q000032:analysis; D015314:Dialysis Solutions / Q000008:administration & dosage*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000276:immunology / Q000628:therapy; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D006435:Renal Dialysis / Q000295:instrumentation*; D013242:Sterilization / Q000379:methods*
D015314:Dialysis Solutions; D008567:Membranes, Artificial; D015933:Complement C3d