Anaphylatoxins C3a and C5a Adsorption on Acrylonitrile Membrane of Hollow-fiber and Plate Dialyzer – an in Vivo Study

Kandus, A.; Ponikvar, Rafael; Drinovec, Jože; Kladnik, S.; Ivanovich, Peter

doi:10.1177/039139889001300308

Cited by 28 publications

(11 citation statements)

References 7 publications

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“…However, the complement components C3a and C5a [2], inflammatory mediators, and the complement factor D [3], a 24-kilodalton molecule needed for complement activation, are adsorbed by these membranes, thereby minimizing biological reactions triggered by complement activation. In addition, cytokines and the complement factor D are efficiently removed using highly permeable membranes or a high efficiency treatment mode such as hemodiafiltration, which also suppress some biological responses resulting from blood-membrane interactions.…”

Section: Biological Responses Elicited By Blood-membrane Interactionsmentioning

confidence: 99%

Evaluation of the Biocompatibility of Dialysis Membranes

Kokubo

Kurihara²,

Kobayashi³

et al. 2015

Blood Purif

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Background: Improvements in the biocompatibility of dialysis membranes have reduced biological responses elicited by blood-membrane interactions. In this article, recent technological developments in dialysis membranes with regard to biocompatibility and recent progress in the evaluation of the biocompatibility of dialysis membranes are reviewed. Summary: The focus of investigation into dialysis membranes in recent years has focused on not only membrane materials, but also their surface textures, which have been changed, for example, by coating with vitamin E or by changing the amount and type of hydrophilizing agents used. Research and development is directed at altering the chemical and physical properties of membrane surfaces to suppress biological responses that are particularly elicited as a result of platelet activation. To develop membranes with excellent biocompatibility, biocompatibility should be evaluated on a like-for-like basis under conditions that are similar to those in clinical settings. Evaluation using actual dialyzers can be performed using porcine blood, platelet-rich plasma isolated from porcine blood (and platelet-rich plasma with leukocytes), or suspension of neutrophils isolated from porcine blood or cultured human monocytes. Key Messages: Highly biocompatible dialysis membranes can be developed when the overall correlations among biological reactions are examined by integrating all data on biological responses elicited by blood-membrane interactions or mutual interactions among blood cells.

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Section: Biological Responses Elicited By Blood-membrane Interactionsmentioning

confidence: 99%

Evaluation of the Biocompatibility of Dialysis Membranes

Kokubo

Kurihara²,

Kobayashi³

et al. 2015

Blood Purif

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“…Numerous studies rapidly established AN69 as a reference in this respect in comparison to other membranes [6,7]. The superior biocompatibility of AN69 stems from the unique adsorptive capacity for the anaphylatoxic and inflammatory complement factors [8][9][10]. Other markers of biocompatibility used to rank dialysis membranes, such as release of elastase from activated granulocytes [11], loss of platelets due to adhesion to the membrane surface [12], platelet activation leading to release of β-thromboglobulin [13] and undesirable cell activation [14] all confirm the preference for AN69.…”

Section: The World's First Biocompatible Membranementioning

confidence: 99%

AN69: Evolution of the World’s First High Permeability Membrane

Thomas¹,

Moriyama²,

Ledebo

2011

Contributions to Nephrology

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In response to a request from the French government, Rhône-Poulenc started development of a synthetic membrane for dialysis in 1969. When used for patients the new membrane, AN69, showed improved efficiency and clinical outcome. Treatment times could be reduced, peripheral neuropathy improved and patients expressed improved quality of life. This was the introduction of high-flux, volume-controlled dialysis. The polymer used for the AN69 membrane is a copolymer of acrylonitrile and sodium methallylsulfonate, specially selected for the dialysis application. Contrary to most synthetic membranes AN69 is hydrophilic, because the numerous sulfonate groups attract water and create a hydrogel structure which provides high diffusive and hydraulic permeability. In the AN69 membrane the microstructure and the chemical composition offer a unique context for bulk adsorption of low-molecular-weight proteins, the high water content of the hydrogel making the polymer chains easily accessible. The highly specific adsorptive properties - limited on the surface and favored in the membrane structure and with high specificity for basic, medium-sized proteins - distinguish AN69 from other synthetic high-flux membranes as well as from other so-called adsorptive membranes in the field of dialysis. Since its creation in the early 1970s the AN69 membrane has evolved to meet the requirements and challenges of dialysis therapy. Still the basic characteristics of high permeability to fluid and to a wide range of relevant uremic retention products combined with excellent biocompatibility, whether measured by traditional or novel indicators, have remained the hallmark of the membrane. The unique adsorptive capacity has provided a base for further development. The latest version of AN69, HeprAN, has heparin grafting on the inner surface and enhanced adsorption of bacterial products on the outer surface. Modern versions of AN69 are today used in hemodialysis and contemporary modes of convective therapies for a large number of chronic as well as acute renal patients around the world.

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“…The three dialysis techniques were employed as follows: (1) BD was performed using a polyamide low-flux membrane (Gambro 8L dialyzer) and a dialysate, the composition of which was (in mmol/l): Na + 140, Cl -109.5, HCO 3 -34, Mg 2+ 0.5, CH 3 COO -3, Ca 2+ 1.75, K + 2, and glucose 5.55. (2) AFB was performed using a polyacrylonitrile membrane (AN69ST; Hospal Nephral 300 dialyzer) and a dialysate, the composition of which was as follows (in mmol/l): Na + 139, Cl -145.74, Mg 2+ 0.37, Ca 2+ 2, K + 2, and glucose 5.55.…”

Section: Treatment Definitionmentioning

confidence: 99%

Acetate-Free Hemodialysis: A Feasibility Study on a Technical Alternative to Bicarbonate Dialysis

Duranti

2004

Blood Purif

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This study aimed at evaluating the feasibility of an acetate-free hemodialysis (AFHD) technique, comparing it with acetate-free biofiltration (AFB) and bicarbonate dialysis (BD). The assessment of the parameters concerned: electrolyte kinetics (Na⁺, K⁺), acid-base balance (HCO₃^–, pH), dialysis efficiency (Kt/V), serum β₂-microglobulin reduction ratio, nutritional status (normalized protein catabolic rate, serum albumin and total proteins, body mass index), hemopoietic status (hemoglobin, hematocrit), and some clinical parameters (systolic and diastolic blood pressures, heart rate, percent blood volume reduction measured by Hemoscan^®). Nine patients participated in this study which was conducted using a Latin square randomized experimental design. The results of the last week of each month of the study (1 month for each technique) were analyzed by means of Anova for repeated measures. The different treatments were comparable with regard to the main dialysis parameters such as blood flow (320 ml/min) and weight loss rate (0.6 ± 0.1 kg/h), while dialysis length and dialysate conductivities were different, depending on the dialysis technique. Electrolyte kinetics and acid-base balance were similar during the three periods. The dialysis efficiency for small molecules (Kt/V of urea) was similar (between 1.4 and 1.6); however, AFB seemed to show a higher β₂-microglobulin reduction rate (47.6 ± 4 vs. 4.3 ± 10% for AFHD and vs. 9.9 ± 5% for BD; p < 0.001). The nutritional and hemopoietic status maintained stable, and the hemodynamic parameters were comparable during all periods. The percent blood volume reduction at the end of the treatments was not statistically different (–14.9 ± 9.4% in AFB, –12.1 ± 5.1% in AFHD, and –12.2 ± 4.4% in BD), and these results could explain the similar hemodynamic behavior during the three periods. In conclusion, AFHD appears to be a safe technique which has all positive effects of AFB and the low costs of BD. In our opinion, it could be used in patients with few clinical impairments, usually treated with hemodialysis, in whom a biocompatible treatment is indicated.

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Anaphylatoxins C3a and C5a Adsorption on Acrylonitrile Membrane of Hollow-fiber and Plate Dialyzer – an in Vivo Study

Cited by 28 publications

References 7 publications

Evaluation of the Biocompatibility of Dialysis Membranes

Evaluation of the Biocompatibility of Dialysis Membranes

AN69: Evolution of the World’s First High Permeability Membrane

Acetate-Free Hemodialysis: A Feasibility Study on a Technical Alternative to Bicarbonate Dialysis

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