Possible Role of Dialysis Membrane Characteristics in Amyloid Osteoarthropathy

Vandenbroucke, Jm.; Jadoul, Michel; Maldague, B.; Huaux, J P; Noël, H.; Strihou, Charles van Ypersele de

doi:10.1016/s0140-6736(86)91188-8

Cited by 81 publications

(17 citation statements)

References 8 publications

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“…In vitro, the evi dence for the former hypothesis is contradictory [34][35][36][37][38], Whether the rise in serum |TM levels during CUP HD can be attributed solely to fluid shifts is also uncertain. When p2M concentrations are adjusted for intradialytic changes in plasma volume, increases in concentration of this pro tein of between 10 and 40% have been reported [7,[39][40][41][42][43][44][45][46][47][48][49][50]. However, as free (TM is distributed in the total extra cellular water, Bergstrom and Wehle [18] have argued that it is more appropriate to correct serum p2M levels for ultrafiltration by estimating changes in ECV.…”

Section: Discussionmentioning

confidence: 99%

Effect of Dialyzer Reprocessing with Renalin on Serum Beta-2-Microglobulin and Complement Activation in Hemodialysis Patients

Westhuyzen¹,

Foreman

Battistutta

et al. 1992

Am J Nephrol

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The peracetic acid-based sterilant Renalin® is increasingly being used for reprocessing hemodialyzers. In order to evaluate the effects of reprocessing on (32-microglobulin (β₂M) kinetics and complement activation in chronic hemodialysis patients, we compared 4 dialyzer membranes on 1st, 2nd and 4th use of the membrane. Dialysis with new cuprammonium rayon dialyzers (0.8 m²) for 4 h resulted in a nonsignificant increase in serum β₂M concentrations of 10.7% (corrected for changes in extracellular volume) and significant generation of the complement component C3a des Arg. On reuse, minimal changes in serum β₂M levels were noted and complement activation was absent. Dialysis with new cellulose acetate (CA, 1.5 m²), polyacrylonitrile (AN69 HF, 1.6 m²) or polymethylmethacrylate (PMMA, 1.6 m²) membranes resulted in significant decreases in serum β₂M levels (19.5, 31.7 and 50.8%, respectively). Reprocessing had negligible effects on the removal of β₂M by CA and AN69, but by the 4th use halved the effectiveness of PMMA. Reprocessing reduced the significant generation of C3a des Arg observed with new CA and PMMA membranes. We conclude that, except for PMMA, Renalin reprocessing has minor effects on the ability of the membranes to remove β₂M and improves the biocompatibility of all membranes studied.

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Section: Discussionmentioning

confidence: 99%

Effect of Dialyzer Reprocessing with Renalin on Serum Beta-2-Microglobulin and Complement Activation in Hemodialysis Patients

Westhuyzen¹,

Foreman

Battistutta

et al. 1992

Am J Nephrol

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“…8], and monocyte activ ity [5] are also significantly impaired. Earlier studies of lymphocyte numbers or their subset proportions have shown that counts of either T or B lymphocytes are often significantly reduced in hemodialyzed patients [9. 10], Significant changes were detected particularly in patients who were hemodialyzed for long time periods [6], Re cently, new hemodialysis membranes have been intro duced which are reported to improve the overall clinical condition of dialyzed patients, mainly by reducing the incidence of complications of hemodialysis such as amy loidosis, carpal tunnel syndrome and joint abnormalities [11,12]. However, no data are yet available on immune parameters of patients treated with these membranes.…”

Section: Introductionmentioning

confidence: 99%

Normal T Lymphocyte Function in Patients with End-Stage Renal Disease Hemodialyzed with ‘High-Flux’ Polysulfone Membranes

et al. 1990

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T lymphocyte function was analyzed in patients hemodialyzed with ‘high-flux’ polysulfone membranes, which have been reported to improve the patients’ overall clinical condition and well-being. For comparison purposes, patients treated by the use of ‘low-flux’ cuprophane membranes were also studied. Peripheral blood white cell counts, numbers of lymphocytes as well as the numbers of T cells and their CD4 and CD8 subsets were within normal range in both patient groups. The absolute number of B cells was slightly decreased in cuprophane-membrane- but not polysulfone-membrane-treated patients. The proliferative response of T lymphocytes after stimulation with optimal concentration of phytohemagglutinin (PHA) was normal in patients treated with ‘high-flux’ membrane dialysis but significantly reduced in those treated with cuprophane membranes. The generation of interleukin-2 (IL-2) receptor on T lymphocytes after PHA stimulation was normal in the polysulfone-membrane-treated group and slightly impaired in the cuprophane-membrane-dialyzed patients. Production of both IL-2 and interleukin-1, as well as the natural killer cell activity, in patients treated by ‘high-flux’ membrane dialysis were also comparable to controls. The levels of serum β₂-microglobulin were significantly elevated in patients-maintained on ‘high-flux’ dialysis membranes but did not reach the levels seen in patients dialyzed by cuprophane membranes. The pY microglobulin at levels seen in patients on cuprophane dialysis had no effects on activation and proliferation of control lymphocytes in vitro. These results suggest that impaired functional responses of T lymphocytes seen in end-stage disease patients on prolonged hemodialysis with cuprophane membranes are not seen in similar patients hemodialyzed with polysulfone membranes.

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“…Several authors [5,8,9] showed that 02irt levels rise more than explained by hemoconcentration in patients dialyzed with cuprophane membranes, but not in patients dialyzed with PAN or polysulfone mem branes. In a controlled longitudinal study we showed that steady-state predialysis 02m lev els decreased within 2 weeks when highly permeable polysulfone membranes were used only to reach initial levels when pa tients were reexposed to cuprophane.…”

Section: Are High P2m Levels In Dialysis Patients Merely the Results Omentioning

confidence: 99%

Beta-2-Microglobulin-Derived Amyloid- Problems and Perspectives

Ritz

Bommer²

1988

Blood Purif

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Possible Role of Dialysis Membrane Characteristics in Amyloid Osteoarthropathy

Cited by 81 publications

References 8 publications

Effect of Dialyzer Reprocessing with Renalin on Serum Beta-2-Microglobulin and Complement Activation in Hemodialysis Patients

Effect of Dialyzer Reprocessing with Renalin on Serum Beta-2-Microglobulin and Complement Activation in Hemodialysis Patients

Normal T Lymphocyte Function in Patients with End-Stage Renal Disease Hemodialyzed with ‘High-Flux’ Polysulfone Membranes

Beta-2-Microglobulin-Derived Amyloid- Problems and Perspectives

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Possible Role of Dialysis Membrane Characteristics in Amyloid Osteoarthropathy

Cited by 81 publications

References 8 publications

Effect of Dialyzer Reprocessing with Renalin on Serum Beta-2-Microglobulin and Complement Activation in Hemodialysis Patients

Effect of Dialyzer Reprocessing with Renalin on Serum Beta-2-Microglobulin and Complement Activation in Hemodialysis Patients

Normal T Lymphocyte Function in Patients with End-Stage Renal Disease Hemodialyzed with &lsquo;High-Flux&rsquo; Polysulfone Membranes

Beta-2-Microglobulin-Derived Amyloid- Problems and Perspectives

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Product

Resources

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Normal T Lymphocyte Function in Patients with End-Stage Renal Disease Hemodialyzed with ‘High-Flux’ Polysulfone Membranes