Dialyzer membrane type and reuse practice influence polymorphonuclear leukocyte function in hemodialysis patients

Area of Science:

• Nephrology
• Immunology
• Biomedical Engineering

Background:

• Polymorphonuclear leukocyte (PMNL) production of reactive oxygen species (ROS) is linked to hemodialysis (HD)-associated morbidity.
• The specific effects of dialyzer membrane type and reuse on PMNL function remain incompletely understood.

Purpose of the Study:

• To investigate the association between patient and dialysis-related factors and PMNL function in regular HD patients.
• To determine how dialyzer membrane material and reuse practices influence PMNL oxidative response.

Main Methods:

• Cross-sectional study of HD patients at enrollment in the Hemodialysis (HEMO) Study.
• Assessed PMNL function via PMA- and N-formyl methionyl-leucyl-phenylalanine (fMLP)-induced respiratory burst and phagocytic activity against Staphylococcus aureus.

Main Results:

• Polysulfone (PS) and cuprophane (CU) membranes showed higher PMA-induced respiratory burst than substituted cellulose (CA/CT) membranes, irrespective of reuse.
• Dialyzer reuse with bleach was linked to increased PMA-induced PMNL superoxide production; renalin as a germicide also increased phagocytosis.
• Longer duration on HD correlated inversely with PMA-induced PMNL superoxide response; poorer functional status correlated with weaker fMLP response.

Conclusions:

• Dialyzer membrane type and reuse significantly influence PMNL oxidative response in HD patients.
• Further prospective studies are needed to evaluate the clinical implications of these findings on patient morbidity.