Intra- and post-dialytic platelet activation and PDGF-AB release: cellulose diacetate vs polysulfone membranes.
BACKGROUND
During haemodialysis the blood-membrane contact causes a release of platelet granule content, which contains platelet-derived growth factor AB (PDGF-AB). In view of the potential role of this in altering biocompatibility during haemodialysis, we evaluated the intra- and post-dialytic changes in PDGF-AB serum levels during haemodialysis sessions performed with cellulose diacetate (CDA) and polysulfone (PS) membranes respectively.


METHODS
PDGF-AB, platelet factor 4 (PF4), beta thromboglobulin (betaTG), and mean platelet volume (MPV) levels were determined in 30 patients, each of whom underwent six dialysis sessions: three with a CDA and three with a PS membrane. Blood samples were taken at times 0, 15, 30, 120, 180, and 240 min during dialysis and at 1, 4, and 20 h after the end of the session. Statistical analysis was performed using a one-way ANOVA and Student's t test.


RESULTS
PDGF-AB at 15 min was increased to +41+/-9% with CDA vs +20+/-5% with PS (P<0.001) from the T0 values, and at 120 min it was +19+/-8% with CDA vs -25+/-9% with PS (P<0.001) from T0 levels. At 240 min it was +95+/-14% with CDA vs +49+/-15% with PS (P<0.001) from the T0 values, returning to basal only 20 h after the end of the session. betaTG at 15 min was +60+/-8% for CDA vs +24+/-7.5% for PS (P<0.001) from the T0 values. PF4 showed a similar trend to betaTG. MPV at 30 min from the start of dialysis was 7.4+/-0.3 fl with CDA and 8+/-0.3 fl with PS (P<0.001), and at 240 min MPV was 7.9+/-0.3 fl with CDA and 8.4+/-0.3 fl with PS (P<0.001).


CONCLUSIONS
Platelet activation and platelet release reactions are lower with PS than with CDA membranes. PDGF-AB, released during and after dialysis, represents a clear biocompatibility marker. Its slow return to basal values and its action on vascular cells make it a potential risk factor for atherosclerosis in uraemic patients.
Cianciolo
G
G
Department of Clinical Medicine and Applied Biotechnology, St Orsola University Hospital, via Massarenti 9, 40138 Bologna, Italy.
Stefoni
S
S
Donati
G
G
De Pascalis
A
A
Iannelli
S
S
Manna
C
C
Colì
L
L
Bertuzzi
V
V
La Manna
G
G
Raimondi
C
C
Boni
P
P
Stefoni
V
V
D001672:Biocompatible Materials; D002482:Cellulose / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy*; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D015539:Platelet Activation; D010978:Platelet Factor 4 / Q000032:analysis; D010982:Platelet-Derived Growth Factor / Q000032:analysis / Q000378:metabolism*; D011108:Polymers; D006435:Renal Dialysis / Q000295:instrumentation / Q000379:methods; D013450:Sulfones; D001620:beta-Thromboglobulin / Q000378:metabolism
D001672:Biocompatible Materials; D008567:Membranes, Artificial; D010982:Platelet-Derived Growth Factor; D011108:Polymers; D013450:Sulfones; D001620:beta-Thromboglobulin; C017662:polysulfone P 1700; D010978:Platelet Factor 4; D002482:Cellulose; C026170:cellulose diacetate