Intradialytic hypoxemia, leukopenia and coagulation system activation were monitored in 9 uremic patients during hemodialysis with cuprophane (Cu) and polysulfone (Psf) membranes, using the following parameters: polymorphonuclear count (PMN), elastase alpha-1 proteinase inhibitor (EI-α1PI) complex, platelet count, β-thromboglobulin (BTG), fibronectin (FN) and arterial oxygen tension (PaO2).
Our results indicate that 1) intradialytic hypoxemia observed with both membranes does not seem to be exclusively related to the well-known membrane-dependent leukopenia; 2) platelet activation, as demonstrated by the plasma BTG increase, appears to be an exclusive cellulosic membrane-related phenomenon; 3) at the same time platelet activation seems to be the major factor responsible for high FN levels, the highest FN levels occurring concurrently with the lowest platelet count.
HorlW.H., SchaeferR.M., HeidlandA.Effects of different dialysers on proteinase inhibitor during hemodialysis.Am J Nephrol1985; 5: 320–6.
2.
CraddockP.R., FehrJ., DalmassoA.D.Hemodialysis leukopenia: pulmonary vascular leukostasis resulting from complement activation by dialyser cellophane membranes.J Clin Invest1977; 59: 879–88.
3.
AlijamaP., BirdP.A.E., WardM.K.Hemodialysis-in-duced leukopenia and activation of complement: effects of different membranes.Proc Eur Dial Transplant Ass1978; 15: 144–53.
4.
KnudsenF., NielsenA.H., PedersenJ.O.Leukopenia and release of granulocyte elastase interlinked membrane-dependent events during hemodialysis.Kidney Int1985; 28: 791–6.
5.
De BackerW.A., VerpootenG.A., BorgonjonD.J.Hypoxemia during hemodialysis: effects of different membranes and dialyzate composition.Kidney Int1983; 23: 738–43.
6.
SherlockJ., LedwithJ., LetteriJ.Hypoventilation and hypoxemia during hemodialysis: reflex response to removal of CO2 across a dialyser.Trans Am Soc Artif Internal Organs1977; 23: 406–19.
HakimR.M., LowrieE.G.The relative effect of leukopenia and dialysate composition on the dialysis-associated hypoxemia.Proc Clin Dial Transplant Forum1980; 10: 190–5.
9.
SherlockJ., LedwithJ., LetteriJ.Determinants of oxygenation during hemodialysis and related procedure.Am J Nephrol1984; 4: 158–68.
10.
OhM.S., UribarriJ., Del MonteM.L., HeneghanW.F.A mechanism of hypoxemia during hemodialysis: consumption of CO2 in metabolism of acetate.Am J Nephrol1985; 5: 366–71.
11.
MarshallJ.W., AhearnD.J., NothumR.J.Adherence of blood components to dialyzer membranes, morphological studies.Nephron1974; 12: 157–70.
12.
BjornsonJ.Thrombus formation in the artificial kidney.Scand J Urol Nephrol1978; 12: 151–257.
13.
SreehranN., CrowM.J., SalterM.C.P.Membrane effect of platelet function during hemodialysis: a comparison of cuprophane and polycarbonate.Artif Organs1982; 6: 324–7.
14.
KaplanK.L., OwenJ.Plasma levels of beta-thromboglobulin and platelet factor 4 as indices of platelet activation in vivo.Blood1981; 57: 199–202.
15.
SabaT.M., LuzioN.R.Reticuloendothelial blockade and recovery as a function of opsonin activity.Am J Physiol1969; 216: 197–205.
16.
SabaT.M.Recituloendothelial system host defence after surgery and traumatic shock.Circ Shock1975; 2: 91–7.
17.
RichardsP.S., SabaT.M.Alterations of fibronection and reticuloendothelial phagocytic function during adaptation to experimental shock.Circ Shock1983; 10: 189–98.
18.
MosherD.F., WilliamsE.M.Fibronectin concentration is decreased in plasma of severely ill patients with disseminated intravascular coagulation.J Lab Clin Med1978; 91: 729–35.
19.
HyersT.M.Pathogenesis of adult respiratory distress syndrome: current concepts.Semin Respir Med1981; 2: 104–8.
20.
PertpsaG., MastrolittiG., FracassoA., MannoC., SchenaF.P.Effect of fibronectin on Fc and C3b receptor mediated-phagocytosis by peripheral blood monocytes of uremic patients.Xth International Congress of Nephrology London, 1987; 171(Abstracts)
21.
StreicherE., SchneiderH.Polysulfone membrane mimicking human glomerular basement membrane.Lancet1983; 2: 1136.
22.
PiazoloP., BrechW.Clinical tolerance test of a new polysulfone membrane.Contr Nephrol1985; 46: 118–26.
23.
AmadoriA., CandiP., SasdelliM.Hemodialysis leukopenia and complement function with different dialyzers.Kidney Int1983; 24: 775–81.
24.
SchaeferR.M., HeidlandA., HorlJ.H.Release of leukocyte elastase during hemodialysis.Contr Nephrol1985; 46: 109–17.
25.
RichardsW.O., ScovillW.A., ShinB.Opsonic fibronectin deficiency in patients with intraabdominal infection.Surgery1983; 94, 2: 210-6.
26.
EriksenH.O., TranebjaergL., ClemmensenI.Plasma fibronectin concentration in patients with chronic renal failure treated with hemodialysis.Scand J Lab Invest1983; 43: 723–6.
