Abstract
BackgroundWe evaluated the biocompatibility and small protein permeability of a newly developed hydrophilic-coated membrane dialyzer (NV) compared with conventional polysulfone dialyzer (APS) for hemodialysis (HD) therapy.MethodsIn a prospective crossover study, 11 maintenance HD patients (7 males; mean age 67.0 ± 10.2 years) received HD three times a week for 4 weeks with the NV membrane and then for another 4 weeks with the APS membrane. We evaluated the variation in several parameters including white blood cell (WBC) count and fibrinogen as indexes for biocompatibility. The plasma and dialysate concentrations of β2-microglobulin (β2-M), α1-microglobulin (α1-M), and albumin were measured at baseline and after 4 h of each study treatment in order to assess the removal of small proteins.ResultsReductions in the WBC count were seen with APS compared with NV at 60 min (NV 5.65 ± 1.60, APS 5.17 ± 1.65 × 103/μL, p < 0.05) and 240 min (NV 5.28 ± 1.38, APS 4.63 ± 1.2 × 103/μL, p < 0.005) after the start of HD. With NV, we found significantly greater rates of variation of β2-M (NV 45.5 ± 1.2, APS 40.1 ± 1.2%, p < 0.0001), α1-M (NV 41.2 ± 9.9, APS 34.2 ± 18.5%, p < 0.05), and albumin (NV 31.6 ± 7.8, APS 18.1 ± 6.5%, p < 0.0001) during HD than with APS. However, there were no significant differences in the removal of β2-M between the two dialyzers.ConclusionsThe clinical characteristics of NV may reveal an improved biocompatibility and a comparable efficiency in small protein removal as compared to those of APS.Trial registrationClinical effects of polysulfone membrane, NV-13U UMIN000011764
Highlights
We evaluated the biocompatibility and small protein permeability of a newly developed hydrophilic-coated membrane dialyzer (NV) compared with conventional polysulfone dialyzer (APS) for hemodialysis (HD) therapy
Reductions in the white blood cell (WBC) count were seen with a conventional PS (APS) compared with NV at 60 min (NV 5.65 ± 1.60, APS 5.17 ± 1.65 × 103/μL, p < 0.05) and 240 min (NV 5.28 ± 1.38, APS 4.63 ± 1.20 × 103/μL, p < 0.005) after the start of HD (Fig. 1)
The change ratios of the WBC count were significantly smaller with NV than with APS after 60 min (NV 96.3 ± 2.3, APS 92.5 ± 7.5%, p < 0.01) and 240 min (NV 91.3 ± 2.3, APS 84.6 ± 11.3%, p < 0.05) (Fig. 2)
Summary
We evaluated the biocompatibility and small protein permeability of a newly developed hydrophilic-coated membrane dialyzer (NV) compared with conventional polysulfone dialyzer (APS) for hemodialysis (HD) therapy. Biocompatibility and middle molecule clearance of hemodialysis (HD) membranes affect the survival, morbidity, and quality of life of uremic patients undergoing maintenance HD therapy. TORAYLIGHT® NV dialyzer (NV; Toray Industries, Inc., Tokyo, Japan) is expected to have different characteristics from the conventional PS due to its newly developed hydrophilic-coated membrane [3]. We designed this prospective, crossover study to evaluate the biocompatibility and low-molecular-weight protein permeability (small protein permeability) of NV compared with a conventional PS (APS; ASAHIKASEI Industries, Inc., Tokyo, Japan).
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