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Changes in Mac-1 and CD14 expression on monocytes and serum soluble CD14 level during push/pull hemodiafiltration
Kenji Kawabata1, Shigeru Nakai, Masamiki Miwa
1Department of Internal Medicine, Daiko Medical Center, Nagoya University School of Medicine, Nagoya, Japan.
Nephron
|February 28, 2002
Summary
Push/pull hemodiafiltration (HDF) with polysulfone (PS) membranes shows reduced monocyte activation compared to regenerated cellulose (RC) membranes. This suggests push/pull HDF may be a safer hemodialysis option.
Area of Science:
- Nephrology
- Immunology
- Biomaterials
Background:
- Dialysate pyrogens pose risks in hemodialysis.
- Assessing the safety of treated dialysate in push/pull hemodiafiltration (HDF) is crucial.
Purpose of the Study:
- Evaluate monocyte activation during hemodialysis with different membranes.
- Compare the safety of push/pull HDF with polysulfone (PS) membranes versus hemodialysis with regenerated cellulose (RC) and PS membranes.
Main Methods:
- Analyzed monocyte Mac-1 and CD14 expression via flow cytometry.
- Measured serum soluble CD14 (sCD14) using ELISA in 7 patients.
- Cross-over study comparing RC, PS hemodialysis, and PS push/pull HDF.
Main Results:
- Monocyte Mac-1 and CD14 expression increased significantly across all artificial kidney types.
- Serum sCD14 levels remained stable during all treatments.
- Monocyte activation was significantly lower with PS membranes (both hemodialysis and HDF) compared to RC membranes.
Conclusions:
- Push/pull HDF with PS membranes demonstrates less monocyte activation than hemodialysis with RC membranes.
- Push/pull HDF with PS membranes is as safe as hemodialysis with PS membranes regarding monocyte activation.
- Pyrogen-free treated dialysate in push/pull HDF offers a potentially safer alternative.