Biocompatibility of haemodialysis membranes: haemodialysis-related leukotriene B4 and C4 generation. France.
The aim of our study was (1) to verify whether haemodialysis (HD) with cuprophane (CUP) and polyacrylonitrile (PAN) membranes is associated with the release of vasoactive leukotriene (LT) C4 and chemotactic LTB4 and (2) to analyse the respective roles of lipoxygenase and cyclo-oxygenase metabolites of arachidonic acid in membrane bio-incompatibility. The investigation was performed in 10 uremic patients using hollow-fibre dialysers and dialysed successively, in random order, with CUP and PAN membranes. The arterial and venous (from dialyser) blood was sampled for the measurement of biochemical parameters, plasma LTC4, LTB4 and prostaglandins (PG) 6-keto-F1 alpha, E2, F2 alpha and thromboxane B2 before and after 15, 30 and 240 min of HD. Eicosanoids were measured by RIA after prior extraction and HPLC separation.


RESULTS
CUP HD was associated with a marked early leukopenia and a delayed decrease in blood pO2. Simultaneously, plasma LTB4 and LTC4 increased significantly in arterial blood after 30 min of HD and in venous blood at the end of session of 240 min. Cyclo-oxygenase metabolites increased as well, but nonsignificantly, with a maximum at the end of HD. PAN HD did not significantly change white blood cell count, pO2, or plasma eicosanoid levels.


CONCLUSIONS
CUP membranes stimulate the release of proinflammatory and vasoactive LTB4 and LTC4. PAN membrane haemodialysis is without such side effects. The release of LTs may be an additional valuable marker of membrane bioincompatibility.
Hornych
A
A
Department of Nephrology, U-430 INSERM, Broussais Hospital, Paris,
Rémy
P
P
Luong
N
N
Aumont
J
J
Bariéty
J
J
D000180:Acrylic Resins; D000328:Adult; D000368:Aged; D016718:Arachidonic Acid / Q000378:metabolism; D001798:Blood Proteins; D002482:Cellulose / Q000031:analogs & derivatives; D002633:Chemotaxis / Q000502:physiology; D003627:Data Interpretation, Statistical; D015777:Eicosanoids / Q000097:blood; D005260:Female; D006400:Hematocrit; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000628:therapy; D007958:Leukocyte Count; D007975:Leukotriene B4 / Q000378:metabolism*; D017997:Leukotriene C4 / Q000378:metabolism*; D008084:Lipoxygenase / Q000097:blood; D008297:Male; D008422:Materials Testing; D008567:Membranes, Artificial; D008875:Middle Aged; D011451:Prostaglandin-Endoperoxide Synthases / Q000097:blood; D006435:Renal Dialysis / Q000295:instrumentation*
D000180:Acrylic Resins; D001798:Blood Proteins; D015777:Eicosanoids; D008567:Membranes, Artificial; D007975:Leukotriene B4; C010504:polyacrylonitrile; D016718:Arachidonic Acid; D017997:Leukotriene C4; D002482:Cellulose; C009865:cuprammonium cellulose; D008084:Lipoxygenase; D011451:Prostaglandin-Endoperoxide Synthases