The effects of a polyacrylonitrile membrane and a membrane made of regenerated cellulose on the plasma concentrations of erythropoietin during hemodialysis.
In vitro studies have shown that some dialysis membranes significantly adsorb erythropoietin (EPO), a fact that might have an effect on anemia in long-term hemodialysis (HD) patients and on anemia treatment with recombinant human EPO. The purpose of the study was to determine whether the ability of adsorption demonstrated in vitro also has an effect on EPO concentrations in vivo. In a crossover study, the plasma concentrations of EPO were examined in 11 patients on chronic HD during HD using a polyacrylonitrile (AN69) membrane (high in vitro adsorption) plus EPO administered subcutaneously after the HD session, HD using a Cuprophan membrane (low in vitro adsorption) plus EPO administered subcutaneously after the HD session, HD using an AN69 membrane plus EPO administered subcutaneously after the HD session plus EPO administered intravenously immediately before HD, or HD using a Cuprophan membrane plus EPO administered subcutaneously after the HD session plus EPO intravenously immediately before HD. The intradialysis plasma concentrations of EPO (not detectable in the dialysate) determined at the dialyzer inlet and outlet at Minutes 5 and 240 of the procedure did not differ significantly after its subcutaneous administration from its predialysis concentrations with either the Cuprophan or AN69 membrane. A comparison of EPO concentrations between AN69 and Cuprophan did not reveal marked differences either. The course of concentrations after additional EPO intravenous administration was similar with no statistically demonstrable difference between the 2 membranes. In conclusion, under clinical conditions, AN69 and Cuprophan membranes do not differ in their effects on plasma EPO concentrations. The differences in EPO adsorption between AN69 and Cuprophan, demonstrated in vitro, do not seem to be of clinical importance.
Opatrný
K
K
Department of Internal Medicine I, Charles University School of Medicine and University Hospital, Plzen, Czech Republic.
Krouzecký
A
A
Wirth
J
J
Vít
L
L
Eiselt
J
J
D000180:Acrylic Resins; D000181:Acrylonitrile / Q000031:analogs & derivatives; D000327:Adsorption; D000740:Anemia / Q000188:drug therapy / Q000209:etiology; D001672:Biocompatible Materials / Q000737:chemistry*; D002482:Cellulose / Q000031:analogs & derivatives* / Q000737:chemistry; D018592:Cross-Over Studies; D004921:Erythropoietin / Q000008:administration & dosage / Q000097:blood* / Q000737:chemistry / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007279:Injections, Subcutaneous; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects / Q000295:instrumentation*
D000180:Acrylic Resins; D001672:Biocompatible Materials; D008567:Membranes, Artificial; D004921:Erythropoietin; C016892:AN-69; D002482:Cellulose; C009865:cuprammonium cellulose; D000181:Acrylonitrile