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Biocompatibility and risk of infection in haemodialysis patients
1Maine Medical Center, Portland.
Abstract:
Infection remains a major cause of morbidity and mortality in the dialysis patient. Most of these infections are bacterial and often lead to sepsis. In this review the possible influence of the biocompatibility of the dialysis membrane on the incidence of bacterial infections is discussed. Specifically, the role of the membrane on granulocyte function such as phagocytosis, adhesion, and production of reactive oxygen species is shown to be adversely affected by recurrent exposure to complement-activating membranes. Recent clinical studies also support the notion that dialysis with bioincompatible membranes is associated with a higher incidence of clinical infections than membranes that are more biocompatible.
Insights
Dialysis membranes can impact infection risk. Less biocompatible membranes may increase the incidence of bacterial infections and sepsis in dialysis patients by affecting immune cell function.
Area of Science:
- Nephrology
- Immunology
- Infectious Diseases
Background:
- Infection is a significant cause of illness and death in dialysis patients, frequently leading to sepsis.
- Bacterial infections are the most common type of infection in this population.
Purpose of the Study:
- To review the influence of dialysis membrane biocompatibility on the occurrence of bacterial infections.
- To examine how membrane properties affect granulocyte function and clinical infection rates.
Main Methods:
- Review of existing literature on dialysis membrane biocompatibility and infection incidence.
- Analysis of studies investigating the effect of membranes on granulocyte functions (phagocytosis, adhesion, reactive oxygen species).
- Evaluation of clinical studies comparing infection rates with different membrane types.
Main Results:
- Recurrent exposure to complement-activating (less biocompatible) dialysis membranes adversely affects granulocyte function.
- Impaired granulocyte functions include phagocytosis, adhesion, and reactive oxygen species production.
- Clinical studies indicate a higher incidence of infections in patients dialyzed with bioincompatible membranes compared to biocompatible ones.
Conclusions:
- Dialysis membrane biocompatibility plays a crucial role in the incidence of bacterial infections in dialysis patients.
- Bioincompatible membranes may predispose patients to infections by compromising immune defenses.
- Choosing more biocompatible membranes could potentially reduce infection-related morbidity and mortality in dialysis patients.