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Related Experiment Videos

Complement depletion during haemofiltration with polyacrilonitrile membranes

Y Gasche1, M Pascual, P M Suter

  • 1Department of Anaesthesiology, Hôpital Cantonal, Universitaire de Genève, Switzerland.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|January 1, 1996
PubMed
Summary

Continuous veno-venous hemofiltration (CVVH) using Polyacrylonitrile (PAN) filters significantly reduces Factor D levels in critically ill patients with acute renal failure, potentially improving outcomes.

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Area of Science:

  • Nephrology
  • Immunology
  • Biomaterials Science

Background:

  • Polyacrylonitrile (PAN, AN69) dialysis membranes are associated with improved outcomes in critically ill patients.
  • Factor D, crucial for the complement alternative pathway, increases in renal failure and is adsorbed by PAN filters, diminishing its activity.
  • Blood contact with biomaterials activates the complement cascade via the alternative pathway.

Purpose of the Study:

  • To measure the time course of Factor D adsorption onto PAN filters.
  • To assess Factor D blood concentrations during continuous veno-venous hemofiltration (CVVH) in critically ill patients with acute renal failure.

Main Methods:

  • Seven critically ill patients with acute renal failure (ARF) were studied.
  • Factor D levels were measured before, during, and after CVVH using AN69 (PAN) filters.

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Main Results:

  • Factor D levels rapidly decreased to 62% within 2 hours and 51% after 12 hours of CVVH.
  • Factor D levels showed a slight increase to 62% at 24 hours.
  • Sequential use of PAN filters depleted Factor D levels below normal in three patients.

Conclusions:

  • Significant Factor D reduction during CVVH with PAN filters suggests frequent filter changes may reduce alternative pathway activity.
  • CVVH with PAN membranes may offer superior outcomes compared to intermittent dialysis for critically ill patients.