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Depletion of Specific Cell Populations by Complement Depletion
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The Complement System in Dialysis: A Forgotten Story?

Felix Poppelaars1, Bernardo Faria1,2,3, Mariana Gaya da Costa1

  • 1Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, Groningen, Netherlands.

Frontiers in Immunology
|February 10, 2018
PubMed

Insights

Targeting the complement system in dialysis offers a promising strategy to improve patient outcomes. Research highlights the need to explore when and how to best inhibit complement activation during hemodialysis and peritoneal dialysis.

Area of Science:

  • Nephrology
  • Immunology
  • Biochemistry

Background:

  • The complement system plays a crucial role in kidney function and disease.
  • Complement activation during dialysis (hemodialysis and peritoneal dialysis) is a long-standing issue impacting biocompatibility.
  • Recent advances in complement inhibition therapeutics have renewed interest in targeting this system.

Purpose of the Study:

  • To review the role of the complement system in hemodialysis (HD) and peritoneal dialysis (PD).
  • To summarize existing findings on complement activation during dialysis.
  • To explore the therapeutic potential of complement inhibition in dialysis patients.

Main Methods:

  • Literature review of previous findings on complement system activation in nephrology and dialysis.
  • Analysis of short-term and long-term effects of complement activation in dialysis.
  • Discussion of current and future therapeutic strategies involving complement inhibition.

Main Results:

  • Complement activation during dialysis promotes inflammation and coagulation.
  • Long-term dialysis complications like infection, fibrosis, and cardiovascular events are linked to complement.
  • Despite progress in biocompatibility, complement activation remains a relevant issue in HD and PD.

Conclusions:

  • Inhibiting the complement system in dialysis could enhance biocompatibility, efficacy, and long-term patient outcomes.
  • The focus is shifting from whether to inhibit complement to when and how to implement these interventions.
  • Further research and clinical trials are warranted to optimize complement-targeting therapies in dialysis.

Keywords:
complementdialysishemodialysiskidneyperitoneal dialysis

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