Observations on neutropenia associated with haemodialysis

In the first 30 minutes of haemodialysis, in patients with chronic renal failure, there is a dramatic fall in total neutrophil count in the peripheral blood. An hour after the start of dialysis this has returned to normal.We have carried out a series of experiments in an attempt to elucidate the cause of this neutropenia. Both the patient and the membranes of the dialyser appeared to be a necessary combination to produce these changes, which could not be induced by the infusion of blood or saline that had previously been in contact with the dialyser. The composition of the dialysing fluid was not related to the fall of white count, and this fall was repeated when the patient was connected to a second dialyser after recovering from the neutropenia caused by the first. It was only when reusing a kidney, by rinsing it out and resterilizing it, that the neutropenia could be modified, but this was not a constant finding.