Microcirculation as a novel marker of membrane biocompatibility

Area of Science:

• Nephrology
• Biomaterials Science
• Physiology

Background:

• Microcirculation serves as an indicator of biological reactions to dialysis.
• Membrane biocompatibility can be assessed by microcirculatory response to dialysis stress.
• This study investigates the differential biological effects of synthetic membranes on microcirculation.

Purpose of the Study:

• To test the hypothesis that different synthetic hemodialysis membranes elicit distinct biological responses.
• To evaluate the impact of EVAL and hf-PS membranes on microcirculation during hemodialysis.

Main Methods:

• A crossover study involving 16 chronically hemodialyzed patients.
• Transcutaneous oxygen pressure (TcPO2) was measured during treatments with EVAL and hf-PS membranes.
• Dialytic prescription and pharmacologic treatments remained constant throughout the study.

Main Results:

• TcPO2 levels remained similar for both membranes initially.
• During EVAL membrane treatments, TcPO2 returned to baseline by the end of the session.
• With the hf-PS membrane, TcPO2 remained significantly lower towards the end of treatment.
• Arterial blood gas values (paO2, paCO2) showed no significant differences between membranes.

Conclusions:

• TcPO2 measurement is a valuable clinical tool for assessing dialyzer biocompatibility.
• Different synthetic membranes exert varying effects on microcirculation, as indicated by TcPO2.
• The EVAL membrane demonstrated a more favorable impact on microcirculation compared to the hf-PS membrane.