Effect of permeability on indices of haemodialysis membrane biocompatibility.
BACKGROUND
Increases in plasma anaphylatoxins frequently are used as an index of haemodialysis membrane biocompatibility; however, their plasma levels may be influenced by the loss of anaphylatoxins into the dialysate compartment.


METHODS
We compared the generation and compartmental distribution of anaphylatoxins, C3a and C5a, in a high flux and a low flux polysulfone membrane dialyser when whole human blood was recirculated through an in vitro haemodialysis circuit.


RESULTS
Plasma C3a levels in high flux polysulfone (2.31 +/- 0.81 microg/ml) and low flux polysulfone (3.02 +/- 0.98 microg/ml) dialysers were comparable after 120 min (P = NS). In contrast, dialysate C3a in high flux polysulfone (0.65 +/- 0.31 microg/ml) accounted for 37.5 +/- 7.0% of the total detected (plasma + dialysate) C3a mass in the dialysers, while dialysate C3a in low flux polysulfone dialysers (0.01 +/- 0.01 microg/ml) accounted for only 0.3 +/- 0.3% of the total mass (P < 0.05; high flux vs low flux). Anaphylatoxin C5a was undetectable in the dialysate compartment of either dialyser examined.


CONCLUSIONS
Our results indicate that anaphylatoxins readily traverse certain high flux dialysis membranes; consequently, plasma C3a levels may not accurately reflect the C3-activating potential of these membranes.
Masaki
T
T
Veterans Affairs Medical Center, Department of Medicine, University of Utah School of Medicine, Salt Lake City, USA.
Gilson
J
J
Leypoldt
J K
JK
Cheung
A K
AK
D001672:Biocompatible Materials / Q000009:adverse effects; D002482:Cellulose / Q000009:adverse effects / Q000031:analogs & derivatives; D015926:Complement C3a / Q000378:metabolism; D015936:Complement C5a / Q000378:metabolism; D006801:Humans; D066298:In Vitro Techniques; D007688:Kidneys, Artificial / Q000009:adverse effects; D008422:Materials Testing; D008567:Membranes, Artificial; D010539:Permeability; D011108:Polymers / Q000009:adverse effects; D006435:Renal Dialysis / Q000009:adverse effects; D013450:Sulfones / Q000009:adverse effects
D001672:Biocompatible Materials; D008567:Membranes, Artificial; D011108:Polymers; D013450:Sulfones; C017662:polysulfone P 1700; D015926:Complement C3a; D015936:Complement C5a; D002482:Cellulose; C009865:cuprammonium cellulose