The influence of dialyzer geometry on blood coagulation and biocompatibility.
The influence of dialyzer geometry on blood coagulation, heparin requirement and complement activation was studied in fourteen chronic hemodialysis patients. Each patient was dialyzed with two different cuprophan dialyzers, hollow fiber GF 120M and parallel plate Lundia IC5N. Both dialyzers had a wall thickness of 11 microns, surface area of 1.2 m2 and both were sterilized with ethylene oxide. Heparin doses were individually titrated. The mean heparin dose was 6089 +/- 988 U. Platelet count decreased from 218 x 10(9)/l to 193 x 10(9)/l and from 235 x 10(9)/l to 197 x 10(9)/l respectively (hollow fiber/plate dialyzer, ns). The number of leucocytes decreased at 15 min after start of dialysis by 56% and 61% (hollow fiber/plate dialyzer, ns). The heparin requirement, measured as prolongation of whole blood activated coagulation time after identical doses of heparin, were the same in hollow fiber and plate dialysis sessions. The arterial fibrinopeptide A concentrations increased during dialysis from 5.4 to 7.1 nmol/l and 8.5 to 9.6 nmol/l respectively (hollow fiber/plate dialyzer, ns). The residual blood volume in the hollow fiber dialyzers was 1.3 +/- 1.1 ml and in the plate dialyzers 1.5 +/- 0.9 ml (ns). C3a activation, indicated by a marked arterio-venous difference, was observed at 15 min after start of dialysis with hollow fiber as well as plate dialyzers. The arterio-venous difference was less pronounced at the end of dialysis. There were no differences in C3a activation between hollow fiber and plate dialyzers at any timepoint. It is concluded that dialyzer geometry does not significantly influence platelet count, blood coagulation, heparin requirement or complement activation.
Lins
L E
LE
Department of Medicine, Karolinska Hospital, Stockholm, Sweden.
Boberg
U
U
Jacobson
S H
SH
Kjellstrand
C
C
Ljungberg
B
B
Skröder
R
R
D000368:Aged; D001672:Biocompatible Materials; D001777:Blood Coagulation / Q000502:physiology*; D002482:Cellulose / Q000031:analogs & derivatives; D003167:Complement Activation / Q000502:physiology*; D015926:Complement C3a / Q000032:analysis; D004867:Equipment Design; D005260:Female; D005344:Fibrinopeptide A / Q000032:analysis; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D010976:Platelet Count; D006435:Renal Dialysis / Q000295:instrumentation*
D001672:Biocompatible Materials; D008567:Membranes, Artificial; D005344:Fibrinopeptide A; D015926:Complement C3a; D002482:Cellulose; D006493:Heparin; C009865:cuprammonium cellulose