Increased amounts of C3a and the terminal complement complex at high dialysis blood-flow: the relation with dialysis efficiency.
To estimate the influence of blood-flow on complement generation and the relation with dialysis efficacy (KT/V) 10 patients underwent cuprophan hemodialyses for 6 h using low (200 ml/min) or high (400 ml/min) blood-flow (n = 40). Dialysis with high blood-flow compared to low induced a more rapid drop in leukocyte count and a more pronounced leukocyte rebound. Net generation of C3a (microgram/min) was also larger at all 15 measuring points during high blood-flow dialysis and there was significantly larger total generation of C3a (after 3 h p < 0.05, after 6 h p < 0.05) as compared to low blood-flow. Reaching a KT/V of 1.2-1.4 with high blood-flow induced a 40% larger total net generation of C3a and 21% more of TCC than with low blood-flow. Net generation of TCC (AU/min) was higher during the first and last parts of high blood-flow dialysis compared to low. In conclusion, increased blood-flow in order to increase dialysis efficiency (KT/V 1.2-1.4) results in larger net infusion of complement products with possible impact on immune response and complement-associated pathophysiological mechanisms.
Skroeder
N R
NR
Department of Medicine, Karolinska Hospital, Stockholm, Sweden.
Kjellstrand
P
P
Holmquist
B
B
Nilsson
U
U
Jacobson
S H
SH
D015926:Complement C3a / Q000378:metabolism*; D015938:Complement Membrane Attack Complex / Q000378:metabolism*; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D012079:Renal Circulation / Q000502:physiology*; D006435:Renal Dialysis
D015938:Complement Membrane Attack Complex; D015926:Complement C3a