The Production of Platelet-Activating Factor (PAF) during Hemodialysis with Cuprophane Membrane. Does the Calcium Concentration in the Dialysate Play Any Role on It?

Abstract

There is evidence that PAF may be produced during hemodialysis (HD) mainly when using cuprophane membrane (CU). It is also known that PAF production is dependent on the amount of extracellular calcium (E_Ca²⁺). In the present study, we investigated the production of PAF during HD with CU as well as the role of the Ca²⁺ in the dialysate with respect to PAF production. Five hemodialyzed patients were studied in two consecutive HD sessions (the first performed using dialysate without Ca²⁺ and the second with a Ca²⁺ concentration of 3.25 mEq/L) and at different times during the sessions the circulating PAF levels as well as the leukocyte and platelet counts were measured. The results demonstrated that a) PAF was indeed produced during HD with CU, b) the highest PAF levels in blood were observed between 5 and 15 minutes from the beginning of HD, at which time the lowest circulating leukocyte and platelet count were measured and c) PAF levels in blood were inversely proportional to the Ca²⁺ concentration in the dialysate (with the exceptional case of the 15 minutes), although we expected the opposite results.