Dissociation between complement activation, integrin expression and neutropenia during hemodialysis

Rousseau, Yanaelle; Carreno, Marie‐Paule; Poignet, Jean-Louis; Kazatchkine, M. D.; Haeffner‐Cavaillon, Nicole

doi:10.1016/s0142-9612(99)00101-5

Cited by 30 publications

(22 citation statements)

References 29 publications

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“…There were no differences in these parameters among the cellulosemodified membranes. [13] In the present study, which used low-flux cellulose-modified membranes, no changes in Abbreviations: SLED = sustained low efficiency dialysis; IHD = intermittent hemodialysis.…”

Section: Discussionmentioning

confidence: 62%

Acute Effects of Intermittent Hemodialysis and Sustained Low-Efficiency Hemodialysis (SLED) on the Pulmonary Function of Patients under Mechanical Ventilation

2007

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The effects of hemodialysis (HD) on pulmonary function are still controversial. The objective of this study was to evaluate the effect of intermittent hemodialysis (IHD) and sustained lowefficiency dialysis (SLED) on the respiratory mechanics of ICU patients under invasive mechanical ventilation. We prospectively studied 31 patients. Laboratory and respiratory evaluation (static and dynamic compliance and resistance) was performed pre-and post-HD. Forty HD sessions were studied and grouped in: SLED (n = 17; Qa = 200-250 mL/min, Qd = 300 mL/min) and IHD (n = 23; Qa = 250-300 mL/min, Qd = 500 mL/min). There was no difference between the groups according to age, gender, comorbidities, APACHE II, and cause of mechanical ventilation, but pre-HD, patients in the IHD group had higher levels of plasma creatinine (5.4 ± 2.0 vs. 4.2 ± 1.3 mg/dL, p = 0.048) and platelets (286 ± 186 vs. 174 ± 95 10 3 /mm 2 , p = 0.032) and lower arterial pH (7.37 ± 0.07 vs. 7.42 ± 0.05, p = 0.02). The efficiency of the treatment was similar (p > 0.05) with both types of HD regarding fluid removal, urea reduction rate, and decrease in plasma creatinine. Pre-HD, the ventilatory conditions of both groups were similar (p > 0.05) except for pressure support ventilation and airflow resistance. There were no changes (pre-versus post-HD p > 0.05) induced either by IHD or SLED in the ratio PaO 2 /FiO 2 or in any measured ventilatory parameter. In conclusion, neither IHD nor SLED modifies the pulmonary function of patients under mechanical ventilation.

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Section: Discussionmentioning

confidence: 62%

Acute Effects of Intermittent Hemodialysis and Sustained Low-Efficiency Hemodialysis (SLED) on the Pulmonary Function of Patients under Mechanical Ventilation

2007

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“…There are several possibilities of explanation of this finding: clearance of free fragments of oxidatively damaged proteins, adsorption of AOPP to the dialysis membrane and its saturation during dialysis or transient neutropenia during the initial phase of the dialysis procedure [32]. The subsequent significant increase of AOPP could occur possibly due to stimulation of neutrophils via complement activation and possibly other mechanisms [33,34]. Another possibility could be accelerated oxidative stress during dialysis [35], but further studies should be performed to understand the effect of the dialysis treatment on the damage to biological structures.…”

Section: Discussionmentioning

confidence: 99%

Advanced Glycation End Products and Advanced Oxidation Protein Products in Hemodialyzed Patients

Kalousová¹,

Zima²,

et al. 2002

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Chronic renal failure is associated with increased oxidative and carbonyl stresses that contribute to long-term uremic complications. In our study, we determined two markers of these stresses – AGEs (advanced glycation end products) and AOPP (advanced oxidation protein products) in chronic hemodialysis patients in order to find out their relationship to the dialysis treatment. Plasmas of 20 hemodialyzed patients treated with modified cellulose membranes were examined at 0 and 15 min and at the end (i.e. after 4 h) of the dialysis session. AGEs were estimated using a spectrofluorometric method (excitation 350 nm, emission 440 nm) and are expressed in AU (arbitrary units)/g protein. AOPP were determined spectrophotometrically (absorbance at 340 nm) and are expressed in chloramine units per gram of protein (µmol/g). AOPP decrease slightly from 0 to 15 min of the dialysis procedure (4.0 ± 1.5 vs. 3.0 ± 0.9 µmol/g, p < 0.01). However, they are increased at the end of the session (5.0 ± 2.1 µmol/l vs. 15 min, p < 0.01, not significant vs. beginning). On the other hand, AGEs decrease continuously from the beginning to the end of the session (mainly in the first minutes of the dialysis) (1.52 ± 0.34 × 10⁴ AU/g at 0 min, 1.39 ± 0.33 × 10⁴ AU/g at 15 min, p < 0.001 vs. beginning, 1.30 ± 0.33 × 10⁴ AU/g at the end, p < 0.001 vs. beginning, not significant vs. 15 min). Neither AGEs nor AOPP correlate with the age of hemodialyzed patients and with the number of years of the dialysis treatment. AOPP correlate with AGEs before the dialysis session (r = 0.62, p < 0.05) but not after the session (r = 0.29, not significant). According to our results, AGEs may serve more as a marker of chronic damage while AOPP may better describe acute oxidative stress during the dialysis treatment.

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“…The repeated activation of leukocytes by the contact with bioincompatible membranes is a cause of leukopenia [30,31] and is a leading cause of the defective cell-mediated immune response of HD patients that is associated with the conversion of lymphocytes from Th1 to Th2 phenotype and with an overproduction of inflammatory cytokines [7]. …”

Section: Bioincompatibility Microinflammation and Oxidative Stress: mentioning

confidence: 99%

“…These groups trigger intradialytic activation of the complement system and cause leukopenia [31]. Based on this burden of knowledge, two major approaches have been adopted to improve the biocompatibility of regenerated cellulose dialyzer membranes.…”

Section: Strategies To Face Bioincompatibility: Is Antioxidant Therapmentioning

confidence: 99%

Vitamin E as a Functional and Biocompatibility Modifier of Synthetic Hemodialyzer Membranes: An Overview of the Literature on Vitamin E-Modified Hemodialyzer Membranes

et al. 2012

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Along with one century of history, research has provided many solutions for hemodialysis (HD) biomaterials, encompassing several generations of copolymers that have found wide application in the development of hollow-fiber dialyzer membranes. Polysulfone-based biomaterials have gained increasing consideration and are now the gold standard in the production of biocompatible hemodialyzers. However, even the highest biocompatibility now available cannot exclude that dialyzer membranes and the overall extracorporeal circulation may produce at the subclinical level immunoinflammatory reactions and thus an increased cardiovascular risk of patients on regular HD therapy. The lipophilic antioxidant and radical scavenger vitamin E has been used (as α-tocopherol) to modify cellulosic and synthetic hollow-fiber membranes with the ultimate goal to neutralize harmful reactive species and to mimic lipid structures of blood cell plasmalemma and lipoprotein particles. Besides filtration and biocompatibility, this modifier has introduced a third function of dialyzer membranes, namely ‘antioxidant bioactivity’. Vitamin E can also serve as a template molecule to produce synthetic redox-active and -silent (non-antioxidant) modifiers for future generations of dialyzer membranes. This mini-review article describes the evolution of vitamin E-derived copolymers as a generation of biomaterials that has offered a clinical challenge and still represents a chance to further improving the quality of HD therapy.

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Dissociation between complement activation, integrin expression and neutropenia during hemodialysis

Cited by 30 publications

References 29 publications

Acute Effects of Intermittent Hemodialysis and Sustained Low-Efficiency Hemodialysis (SLED) on the Pulmonary Function of Patients under Mechanical Ventilation

Acute Effects of Intermittent Hemodialysis and Sustained Low-Efficiency Hemodialysis (SLED) on the Pulmonary Function of Patients under Mechanical Ventilation

Advanced Glycation End Products and Advanced Oxidation Protein Products in Hemodialyzed Patients

Vitamin E as a Functional and Biocompatibility Modifier of Synthetic Hemodialyzer Membranes: An Overview of the Literature on Vitamin E-Modified Hemodialyzer Membranes

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