Intradialytic granulocyte reactive oxygen species production: a prospective, crossover trial.
By the use of flow cytometric techniques, this prospective, randomized crossover study was designed to analyze intradialytic granulocyte reactive oxygen species (ROS) formation in whole blood with complement-activating and noncomplement-activating hollow fiber membranes. Dialysis with a complement-activating membrane resulted in a 6.5-fold increase in granulocyte hydrogen peroxide production 15 min after dialysis initiation and remained significantly elevated (P < 0.01) through the first 30 min with this membrane in comparison to both predialysis values and simultaneous values with a noncomplement-activating membrane. Further studies demonstrated that blood obtained at 15 min with a complement-activating membrane generated significantly less granulocyte ROS production in response to Staphylococcus aureus incubation than blood obtained either predialysis or at the same time in dialysis with a noncomplement-activating membrane. Both complement-activating and noncomplement-activating dialysis membranes caused slightly decreased granulocyte responsiveness to phorbol myristate acetate. It was concluded that hemodialysis with complement-activating membranes results in increased granulocyte ROS production and decreased responsiveness to S. aureus challenge during the dialysis procedure. These results document the potential role of ROS in hemodialysis-associated pathology and susceptibility to infection.
Division of Nephrology, Maine Medical Center, Portland 04102.
J
J
Himmelfarb
K A
KA
Ault
D
D
Holbrook
D A
DA
Leeber
R M
RM
Hakim
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002482:Cellulose / Q000009:adverse effects / Q000031:analogs & derivatives*; D003167:Complement Activation; D004198:Disease Susceptibility / Q000209:etiology; D004730:Endothelium, Vascular / Q000473:pathology; D005260:Female; D005434:Flow Cytometry; D006098:Granulocytes / Q000187:drug effects / Q000378:metabolism*; D006801:Humans; D007239:Infections / Q000209:etiology; D008297:Male; D008567:Membranes, Artificial; D008768:Methylmethacrylates / Q000009:adverse effects*; D008875:Middle Aged; D011446:Prospective Studies; D017382:Reactive Oxygen Species / Q000378:metabolism*; D006435:Renal Dialysis / Q000295:instrumentation; D016897:Respiratory Burst; D013211:Staphylococcus aureus; D013755:Tetradecanoylphorbol Acetate
D008567:Membranes, Artificial; D008768:Methylmethacrylates; D017382:Reactive Oxygen Species; D002482:Cellulose; C009865:cuprammonium cellulose; D013755:Tetradecanoylphorbol Acetate