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Behaviour of white blood cells and the complement system
D Falkenhagen1, G S Brown, U Thomaneck
1Department of Internal Medicine, University of Rostock, Germany.
Summary
Different dialyzers significantly impact white blood cell counts and complement activation during dialysis. Cuprammonium cellulose dialyzers caused the most significant changes, while PAN copolymer and PMMA dialyzers showed the least adverse effects.
Area of Science:
- Nephrology
- Immunology
- Biomaterials Science
Background:
- Dialysis is a life-sustaining treatment for kidney failure.
- Dialyzer membranes interact with blood components, potentially triggering immune responses.
- Understanding these interactions is crucial for optimizing dialysis safety and efficacy.
Purpose of the Study:
- To compare the biocompatibility of seven different dialyzer types.
- To assess the impact of dialyzers on white blood cell (WBC) counts and complement system activation.
- To identify dialyzers with minimal adverse immunological effects.
Main Methods:
- A controlled crossover study involving five dialysis centers in four countries.
- Investigation of seven distinct dialyzer types with varying membrane materials.
- Monitoring of WBC subsets (monocytes, neutrophils, lymphocytes) and complement activation markers.
Main Results:
- Dialyzers with cuprammonium cellulose membranes (G10-3N, G120 M) induced the most significant changes in WBC counts and complement activation.
- PAN copolymer and PMMA dialyzers (Filtral, T 150) exhibited the least impact on WBCs and complement factors.
- Cellulose acetate and polysulfone membrane dialyzers (Duo-Flux, CD 4000, F 60) showed moderate WBC reduction and minor complement activation.
Conclusions:
- Dialyzer membrane material is a critical determinant of biocompatibility during hemodialysis.
- Cuprammonium cellulose dialyzers are associated with greater immunological activation compared to PAN, PMMA, cellulose acetate, and polysulfone membranes.
- PAN copolymer and PMMA dialyzers represent a more biocompatible option, minimizing adverse effects on the immune system.