Comprehensive Evaluation of Acute Immunological Changes Induced by Cuprophane and Polysulfone Membranes in a Patient on Chronic Hemodialysis

Abstract

We have investigated the acute changes in cytokine gene expression patterns and immune status in vivo and ex vivo in a patient on chronic hemodialysis with cuprophane membranes before and after two hemodialysis sessions with either cuprophane or polysulfone membranes. Results show that both dialyzer membranes have differential acute effects on the immune system and that the concomitant use of reverse-transcriptase-coupled polymerase chain reaction, solid-phase and radioimmunoassays, and flow-cytometric analysis may be useful in the longitudinal assessment of patients on chronic hemodialysis.

Section 5: Dialysis Interventions for Treatment of AKI

“…691 Earlier-generation dialyzer membranes composed of cuprophane or unmodified cellulose were more bioincompatible and had the potential to cause a “dialyzer membrane reaction”, mediated by complement activation, release of proinflammatory markers, and oxidative stress, and manifested clinically by acute hypotension, vasodilatation, leucopenia, hypoxia and fever. 692, 693, 694, 695, 696, 697 More recently, modified cellulosic membranes (with substitution of the hydroxyl groups) and synthetic membranes composed of polyacylnitrile, polysulfone, or poly(methyl methacrylate) have been developed. These “biocompatible membranes” (or less bioincompatible membranes) produce less complement and cytokine activation, and decrease oxidative stress.…”