Biocompatibility of the new anticoagulant dialyzer TORAYLIGHT® NV

Yamaka, Toshihiko; Ichikawa, K.; Saito, Mami; Watanabe, Keiji; Nakai, Ayumu; Higuchi, Naohito; Igarashi, Naoko; Yoshimoto, Hiroshi

doi:10.14340/spp.2014.05c0002

Cited by 14 publications

(16 citation statements)

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“…Specifically, NV-U and CX-U respectively induced the lowest and highest activation of platelets among the tested membranes. This result is probably relevant to observations from a clinical study in which dialysis using NV-U showed smaller changes in platelet parameters than dialysis using CX-U (15).…”

Section: Discussionsupporting

confidence: 61%

Biocompatibility of Polysulfone Hemodialysis Membranes and Its Mechanisms: Involvement of Fibrinogen and Its Integrin Receptors in Activation of Platelets and Neutrophils

et al. 2018

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Activation of blood cells during hemodialysis is considered to be a significant determinant of biocompatibility of the hemodialysis membrane because it may affect patient health adversely through microvascular inflammation and oxidative stress. This study found very different cell activation among various polysulfone (PSf) hemodialysis membranes. For example, CX‐U, a conventional PSf membrane, induced marked adhesion of platelets to its surface and increased surface expression of activated CD11b and production of reactive oxygen species (ROS) by neutrophils; while NV‐U, a hydrophilic polymer‐immobilized PSf membrane, caused little platelet adhesion and slight CD11b expression and ROS production by neutrophils. Analysis of the molecular mechanisms of the above phenomena on CX‐U and NV‐U indicated that anti‐integrin GPIIb/IIIa antibody blocked platelet adhesion, and that the combination of anti‐CD11b (integrin α subunit of Mac‐1) and anti‐integrin αvβ3 antibodies blocked ROS production by neutrophils. Plasma‐derived fibrinogen, a major ligand of GPIIb/IIIa, Mac‐1, and αvβ3 on membranes, was thus analyzed and found to be more adsorbed to CX‐U than to NV‐U. Moreover, comparison between five PSf membranes showed that the number of adherent platelets and neutrophil ROS production increased with increasing fibrinogen adsorption. These results suggested that fibrinogen, adsorbed on membranes, induced GPIIb/IIIa‐mediated platelet activation and Mac‐1/αvβ3‐mediated neutrophil activation, depending on the amount of adsorption. In conclusion, the use of biocompatible membranes like NV‐U, which show lower adsorption of fibrinogen, is expected to reduce hemodialysis‐induced inflammation and oxidative stress by minimizing cell activation.

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Section: Discussionsupporting

confidence: 61%

Biocompatibility of Polysulfone Hemodialysis Membranes and Its Mechanisms: Involvement of Fibrinogen and Its Integrin Receptors in Activation of Platelets and Neutrophils

et al. 2018

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“…PS membranes contain a hydrophilic polymer, polyvinylpyrrolidone (PVP), and it has been reported that PVP might influence biocompatibility [30]. There were several recent reports about a highly biocompatible PS membrane that uses a new hydrophilic polymer in addition to PVP [31][32][33][34][35]. According to these reports, this new PS membrane has superior biocompatibility compared with conventional PS membranes and could improve conditions in hemodialysis patients compared with conventional PS membranes.…”

Section: Discussionmentioning

confidence: 99%

The clinical evaluation of novel polymethyl methacrylate membrane with a modified membrane surface: a multicenter pilot study

et al. 2018

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Background: Polymethyl methacrylate (PMMA) membranes have the unique property of adsorption, which can remove medium-and large-weight molecular substances that cannot be removed by normal hemodialysis and hemodiafiltration. Filtryzer® NF (NF) is a newly developed PMMA membrane that suppresses platelet adhesion on the membrane surface and retains an adsorption property. NF is expected to improve inflammatory conditions and clinical symptoms in hemodialysis patients compared with conventional PMMA membranes.Methods: Thirty-seven maintenance hemodialysis patients treated with polysulfone (PS) membranes and who had detectable chronic inflammation were enrolled into the study. The patients were randomly allocated into the NF and PS groups and observed for 1 year. C-reactive protein (CRP) values were measured as the primary endpoint. Nutrition, blood cell count, and dialysis itchiness were evaluated as secondary endpoints.Results: Significant differences in CRP values were not found between the NF and PS groups. In the PS group, the creatinine generation rate (%CGR) and platelet count, which were included in nutrition and blood cell count, respectively, significantly decreased after 6 and 9 months compared with the start of study, but these parameters did not significantly change in the NF group within 1 year. Dialysis itchiness in the NF group was significantly improved compared with the PS group after 9 months.Conclusions: Our results showed that a new PMMA membrane, NF, has a potential to maintain nutritional conditions and the platelet counts and improve dialysis itchiness.Trial registration: This study is retrospectively registered with the Clinical Trials Registry of the University Hospital Medical Information Network on February 17, 2015 (registration ID, UMIN000016567).

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“…Vitamin‐E‐coated membranes bring benefits primarily by quenching oxidative substances that are generated when blood cells contact the dialysis membrane . The NV dialyzer reduces dialysis‐associated platelet activation by enhancing the water mobility adjacent to the membrane , resulting in reduced dialysis‐associated acute IL‐6 production . Common to these two types of dialysis membrane are an ESA‐sparing potential independent of effects on systemic inflammation and reduced dialysis‐associated acute production of pro‐inflammatory substances.…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Study on Erythropoiesis Stimulating Agent Dose Reducing Potential of an Anti‐Platelet Activation Membrane Dialyzer in Hemodialysis Patients

et al. 2018

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Our previous small‐scale trial demonstrated an erythropoiesis stimulating agent (ESA)‐sparing potential of the TORAYLIGHT NV (NV) dialyzer in hemodialysis patients with high interleukin‐6 levels. We now retrospectively explored this ESA‐sparing potential of the NV dialyzer in 122 and 129 prevalent dialysis patients who were on the NV and conventional polysulfone (PS) dialyzers, respectively, for 12 months. ESA resistance index (ERI) increased with the PS dialyzers whereas neither ERI nor ESA dose changed with the NV dialyzer. Analyses of baseline ERI or ESA dose‐based subgroups revealed a decrease in ERI and ESA dose with the NV dialyzer in patients with a baseline ERI ≥12 IU·dL/week·kg·g Hb (P < 0.05) and in those with a baseline ESA dose >6000 IU/week (P < 0.001), respectively. Neither ERI nor ESA dose improved in the corresponding subgroups on the PS dialyzers. These findings suggest that NV dialyzer can improve ESA responsiveness in hemodialysis patients with advanced ESA resistance.

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Biocompatibility of the new anticoagulant dialyzer TORAYLIGHT® NV

Cited by 14 publications

References 0 publications

Biocompatibility of Polysulfone Hemodialysis Membranes and Its Mechanisms: Involvement of Fibrinogen and Its Integrin Receptors in Activation of Platelets and Neutrophils

Biocompatibility of Polysulfone Hemodialysis Membranes and Its Mechanisms: Involvement of Fibrinogen and Its Integrin Receptors in Activation of Platelets and Neutrophils

The clinical evaluation of novel polymethyl methacrylate membrane with a modified membrane surface: a multicenter pilot study

A Retrospective Study on Erythropoiesis Stimulating Agent Dose Reducing Potential of an Anti‐Platelet Activation Membrane Dialyzer in Hemodialysis Patients

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