Effect of different dialysis membranes on platelet function. A tool for biocompatibility evaluation.
Intradialytic coagulative and platelet activation, one of the main consequences of blood-membrane contact, was studied in a group of 5 RDT patients with a comparative evaluation of 3 different dialytic membranes: Cuprophan (CU), Polysulfone (PS) and Cellulose Triacetate (CT). Each patient underwent 5 consecutive dialysis sessions with the above mentioned membranes. Intradialytic platelet activation was studied through a morpho-functional evaluation between the mean platelet volume (MPV) and Serotonin (S), beta-Thromboglobulin (beta-TG) and Platelet Factor 4 (PF4) serum levels. These determinations were made before HD (time 0) and after 30', 120', and 240'. We also checked the intradialytic status of thrombogenesis and fibrinolysis determining aPTT, thrombin time, fibrinogen, antithrombin III (AT III), alpha-2 antiplasmin and plasminogen, at the same time intervals. All membranes tested (CU, PS, CT) caused appreciable intradialytic platelet activation, above all after 15' and at the end of dialysis sessions, more marked for CU than PS or CT. In particular MPV showed a decrease throughout the session (-5% at 30' and -9% at 240') while S, beta TG and PF4 peripheral blood levels showed a significant increase at the same intervals with CU membrane. Lastly coagulative and fibrinolytic parameters showed no significant differences among any of the membranes tested.
De Sanctis
L B
LB
Institute of Nephrology, St. Orsola University Hospital, Bologna, Italy.
Stefoni
S
S
Cianciolo
G
G
Colì
L
L
Buscaroli
A
A
Feliciangeli
G
G
Borgnino
L C
LC
Bonetti
M
M
Gregorini
M C
MC
De Giovanni
P
P
Buttazzi
R
R
D000328:Adult; D000990:Antithrombin III / Q000032:analysis; D001672:Biocompatible Materials / Q000494:pharmacology; D001792:Blood Platelets / Q000187:drug effects*; D048429:Cell Size / Q000187:drug effects; D002482:Cellulose / Q000031:analogs & derivatives / Q000494:pharmacology; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006493:Heparin / Q000378:metabolism; D006801:Humans; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D010958:Plasminogen / Q000032:analysis; D010976:Platelet Count / Q000187:drug effects; D010978:Platelet Factor 4 / Q000378:metabolism; D011108:Polymers / Q000494:pharmacology; D006435:Renal Dialysis / Q000592:standards*; D012701:Serotonin / Q000097:blood; D013450:Sulfones / Q000494:pharmacology; D013918:Thrombin Time; D000979:alpha-2-Antiplasmin / Q000032:analysis; D001620:beta-Thromboglobulin / Q000378:metabolism
D001672:Biocompatible Materials; D008567:Membranes, Artificial; D011108:Polymers; D013450:Sulfones; D000979:alpha-2-Antiplasmin; D001620:beta-Thromboglobulin; C017662:polysulfone P 1700; D012701:Serotonin; D010978:Platelet Factor 4; D000990:Antithrombin III; D005340:Fibrinogen; D010958:Plasminogen; D002482:Cellulose; D006493:Heparin; C024671:cellulose triacetate; C009865:cuprammonium cellulose