Recently, hypotension and malaise during hemodialysis using polysulfone (PS) membranes have been reported. This study aimed to evaluate the bioincompatibility of eluted substances from PS hemodialysis membranes that can induce hypotension, malaise, and anaphylactic shock. Polyvinylpyrrolidone (PVP) elution from five hemodialysis membranes was measured in an in vitro experimental circulation. Skin prick tests (SPTs) with PVP or the priming fluid of hemodialysis membranes were carried out for seven PS membrane-incompatible patients and seven healthy volunteers. Skin reactivity for histamine was compared in patients and healthy volunteers. The symptoms of PS membrane-incompatible cases were hypotension, dyspnea, nausea, or vomiting. One patient had gone into shock. PVP was eluted from hemodialysis membranes, but the SPT for PVP was negative in all patients. SPTs with priming fluid (or priming fluid effluxed during priming) were positive in four out of six patients. However, the SPT with bisphenol A was positive in one patient. The area of the flare reaction against histamine in patients was smaller than that of healthy subjects. In conclusion, eluted substances apart from PVP from hemodialysis membranes could cause bioincompatibility with PS membranes.
The objectives of this study were to investigate the influence of the sterilization and storage period on elution of polyvinylpyrrolidone (PVP) from wet-type polysulfone (PSu) membrane dialyzers. APS-15SA (APS) dialyzers sterilized by gamma-radiation and RENAK PS-1.6 (RENAK) dialyzers sterilized by autoclaving were compared in this study. Each dialyzer was washed with physiological saline and the amount of PVP eluted from the PSu membrane was measured. Then, experimental use of each dialyzer was performed by circulating physiological saline for 4 hours, after which the PVP eluted from the PSu membrane was measured. As the results, the amount of PVP eluted by washing was positively correlated with the storage period for both dialyzers (APS: rs = 0.958; RENAK: rs = 0.952). In the experimental circuit, the amount of PVP eluted from the RENAK dialyzer was positively correlated with the storage period (rs = 0.810), whereas the amount of PVP eluted from the APS dialyzer was negatively correlated with the storage period (rs = -0.833). We found that the amount of PVP eluted from PSu membrane is quite different by the sterilization and storage period of dialyzers.
Key words:storage period, sterilization method, polyvinylpyrrolidone, polysulfone 〈Abstract〉 The elution of polyvinylpyrrolidone(PVP)from polysulfone(PS)dialysis membranes is one of the important problems in dialysis therapy. The aim of this study was to investigate the influence of sterilization and the storage period on the elution of PVP from wet-type PS dialyzers. Seven APS-15SA(APS)dialyzers sterilized by gradiation and seven RENAK PS-1.6(RENAK)dialyzers sterilized by autoclaving were used in this study. The PVP concentration(conc.
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