Effect of different dialysis membranes on platelet function. A tool for biocompatibility evaluation

Area of Science:

• Nephrology
• Hematology
• Biomaterials Science

Background:

• Blood-membrane interactions during renal replacement therapy (RRT) can lead to coagulative and platelet activation.
• Understanding these interactions is crucial for optimizing dialysis procedures and patient outcomes.

Purpose of the Study:

• To comparatively evaluate the intradialytic platelet activation and coagulation status associated with three different dialysis membranes: Cuprophan (CU), Polysulfone (PS), and Cellulose Triacetate (CT).

Main Methods:

• A study involving 5 RRT patients, each undergoing 5 consecutive dialysis sessions with CU, PS, and CT membranes.
• Intradialytic platelet activation assessed via morpho-functional evaluation, measuring mean platelet volume (MPV) and serum levels of Serotonin (S), beta-Thromboglobulin (beta-TG), and Platelet Factor 4 (PF4) at multiple time points.
• Coagulation and fibrinolysis parameters (aPTT, thrombin time, fibrinogen, AT III, alpha-2 antiplasmin, plasminogen) were also monitored.

Main Results:

• All tested membranes (CU, PS, CT) induced significant intradialytic platelet activation, particularly noticeable after 15 minutes and at the end of dialysis sessions.
• Cuprophan (CU) demonstrated more pronounced platelet activation compared to Polysulfone (PS) and Cellulose Triacetate (CT).
• MPV decreased during dialysis sessions, while S, beta-TG, and PF4 levels increased, especially with the CU membrane. No significant differences in coagulation or fibrinolysis parameters were observed among the membranes.

Conclusions:

• Dialysis membranes, especially Cuprophan, contribute to intradialytic platelet activation.
• The choice of dialysis membrane may influence the degree of platelet activation during RRT.
• Coagulative and fibrinolytic functions appear unaffected by the tested membrane types during RRT.