Abstract
Biocompatibility of hemodialysis (HD) systems have been considerably improved. However, mortality and morbidity rates of patients have remained high, raising questions regarding the biocompatibility of current systems. In the present study, 70 patients on regular HD (51 males; mean age, 63 years; median duration of HD, 18 months) with high-performance membrane (polysulfone, 77%; polymethylmethacrylate, 23%) at Tohoku University Hospital were examined. Blood samples before and after HD, were subjected to measure apoptosis cells of white blood cells, plasma levels of the following molecules: myeloperoxidase (MPO), pentraxin 3 (PTX3), angiogenin, complements, and 17 cytokines. The main findings were as follows: significant decreases in leukocyte counts by dialysis, significant increases in apoptosis-positive leukocytes by dialysis (neutrophils and monocytes), and significant decrease in plasma angiogenin accompanying increase in plasma MPO and PTX3 levels, with no or only marginal changes in plasma pro-inflammatory cytokine levels and complement products by dialysis. The findings underlined the unsolved issue of bio-incompatibility of HD systems, and suggest the possible pathology of neutrophil apoptosis accompanying MPO release for the development of microinflammation in patients on HD.
Highlights
Biocompatibility of hemodialysis (HD) systems have been considerably improved
Significant increases were seen in myeloperoxidase (MPO) and pentraxin 3 (PTX3) levels by HD, while significant decrease was found in thiobarbituric acid-reactive substances (TBARS) (Table 3)
The purpose of this study was to examine the impact of HD on peripheral leukocytes, with particular focus on neutrophils in patients using synthetic polymer membranes
Summary
Biocompatibility of hemodialysis (HD) systems have been considerably improved. mortality and morbidity rates of patients have remained high, raising questions regarding the biocompatibility of current systems. Intrinsic and extrinsic pathological factors are thought to be involved in this elevated mortality rate; the former include underlying kidney disease, comorbidities, nutrition[2], and control of the uremic state of the patient[3], while the latter include the bio-compatibility of materials in the treatment system, such as the dialyzer m embrane[4], and dialysis water quality[5] Biocompatibility in this case refers to biological reactions induced between blood and the dialyzer or dialysate. The cellulose membrane is one of the classic factors for bio-incompatibility, as the structure of cellulose contains hydrophilic hydroxyl groups, which strongly stimulate both activation of complement, and release of cytokines by mononuclear c ells[6] These reactions have been assumed to contribute to chronic inflammation and oxidative stress, leading to a higher risk of CVD and infectious disease in dialysis patients through injury to endothelial cells and immunocompetent c ells[7]. The purpose of this study was to examine the impact on peripheral leukocytes during hemodialysis (HD), with particular focus on neutrophils in patients using synthetic polymer membranes
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
