Effect of polyflux membranes on the improvement of hemodialysis-associated eosinophilia: a case series

Abstract

Hemodialysis-associated eosinophilia (HAE) is believed to be associated with allergic reactions to dialyzer materials. This study aimed to investigate the use of Polyflux membranes to improve HAE. Thirty-one patients suffering from HAE were included. Patients were dialyzed with polysulfone membranes when they developed HAE. After that, patients were dialyzed with Polyflux membranes three times every week, 4 h every time without changing the dialysis parameters and medication. Levels of peripheral eosinophils, hsCRP, IgE, C3a, IL-5 and peripheral CD4+ lymphocytes and CD8+ lymphocytes were assessed before Polyflux treatment, and at 4th, 8th and 12th weeks of treatment. Any symptoms including chest tightness and skin itching were observed during the study period. After 12 weeks of Polyflux membrane dialysis and compared with polysulfone membrane dialysis, levels of peripheral eosinophils were significantly decreased (1.26 ± 0.61 vs. 0.71 ± 0.29 Â 10 9 /L, p50.001); serum IL-5 levels were significantly decreased (24.43 ± 10.21 vs. 9.11 ± 4.21 pg/mL, p50.001); and chest tightness and skin itching were significantly improved (45.2% vs. 19.4%, p ¼ 0.028). After 12 weeks, there was no significant change in serum levels of hsCRP (2.00 ± 0.94 vs. Changing to a Polyflux membrane may alleviate HAE and reduce serum IL-5 levels. Therefore, this could be a strategy to manage HAE in the clinical practice.

Eosinophilia and Kidney Disease: More than Just an Incidental Finding?

“…For patients with peri-dialytic symptoms, eosinophilia and also complement C3a and C5a may be indicative parameters for membrane bio-incompatibility. In these cases, changing the hemodialysis membrane might be beneficial [207,211].…”