Does the surface-treated AN69 membrane prolong filter survival in CRRT without anticoagulation?

Area of Science:

• Nephrology
• Critical Care Medicine
• Biomaterials Science

Background:

• Continuous renal replacement therapy (CRRT) requires anticoagulation, posing risks for bleeding patients.
• The AN69ST membrane, treated with polyethyleneimine, aims to reduce thrombogenicity and allow CRRT without anticoagulation.
• Evaluating AN69ST membrane performance in filter survival without anticoagulation is crucial for patient safety.

Purpose of the Study:

• To assess if the AN69ST membrane prolongs filter survival in CRRT when no additional anticoagulation is used.
• To compare the thrombogenicity of the AN69ST membrane against the original AN69 membrane under heparin-free conditions.

Main Methods:

• A prospective, randomized, double-blind, cross-over trial was conducted.
• 39 patients undergoing continuous venovenous hemofiltration (CVVH) without heparin were included.
• Filter survival was compared between AN69ST and original AN69 membranes.

Main Results:

• Filter survival was 14.2 ± 8.2 hours for AN69ST (n=75) and 13.3 ± 10.3 hours for AN69 (n=76), with no significant difference (p=0.59).
• Analysis of filter clotting interruptions showed similar results: 14.4 ± 8.2 hours for AN69ST (n=62) vs. 14.1 ± 7.5 hours for AN69 (n=56) (p=0.93).

Conclusions:

• The surface-modified AN69ST membrane did not extend filter survival during CVVH without systemic anticoagulation.
• Current CRRT settings and the AN69ST membrane do not offer an advantage over the original AN69 membrane in heparin-free scenarios.