Bioincompatible membranes place patients with acute renal failure at increased risk of infection.
The mortality of critically ill patients with acute renal failure (ARF) requiring hemodialysis remains high (> 50%), even though major improvements in the management of this disorder have been made. Sepsis has been identified as a major cause of death in ARF. Experimental data have suggested that bioincompatible membranes aggravate uremia induced neutrophil dysfunction. In the following two combined prospective, randomized, clinical studies, the effects of the biocompatibility of dialysis membranes on the susceptibility to infection were compared in 72 surgical and medical patients with ARF. The group of patients treated with biocompatible polyacrylonitrile membranes had a significantly lower incidence of bacterial infections and a lower relative and absolute mortality rate due to sepsis, compared to patients treated with bioincompatible cuprophane membranes. These investigations identified bioincompatibility as a factor that adversely affects the prognosis of critically ill patients with ARF.
Schiffl
H
H
Medizinsche Klinik, Klinikum Innenstadt, Ludwig-Maximilians-University, Munich, Germany.
Sitter
T
T
Lang
S
S
König
A
A
Haider
M
M
Held
E
E
D000180:Acrylic Resins / Q000009:adverse effects; D058186:Acute Kidney Injury / Q000150:complications* / Q000628:therapy*; D000328:Adult; D000368:Aged; D001672:Biocompatible Materials / Q000009:adverse effects*; D002482:Cellulose / Q000009:adverse effects / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D007239:Infections / Q000209:etiology*; D007688:Kidneys, Artificial / Q000009:adverse effects*; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D011446:Prospective Studies; D018805:Sepsis / Q000209:etiology
D000180:Acrylic Resins; D001672:Biocompatible Materials; D008567:Membranes, Artificial; C010504:polyacrylonitrile; D002482:Cellulose; C009865:cuprammonium cellulose