Adsorption of unactivated complement proteins by hemodialysis membranes

Hemodialysis using polyacrylonitrile (PAN) membranes has been reported to be associated with depletion of complement in the plasma, yet the increase in plasma C3a antigen concentrations and the degree of leukopenia are modest. These observations suggest that PAN membranes may have a large propensity to adsorb native complement proteins; as a consequence, complement depletion can occur without activation. In the present study, we observed that incubation of human serum in the presence of PAN membrane resulted in a 50% loss of serum hemolytic activity of C3. When radiolabeled purified components were offered, PAN membranes were found to adsorb C3 and C5 in a dose-dependent manner. Adsorption of these proteins by PAN was more than 20 times greater than adsorption by cuprophan, cellulose acetate or Hemophan (Akzo, formerly Enka, Wuppertal, FRG) at all concentrations examined. These results suggest that depletion of complement when serum is exposed to hemodialysis membranes may result from adsorption of complement components onto the membrane surfaces and does not necessarily indicate complement activation.