Evaluation of a Polynephron Dialysis Membrane considering New Aspects of Biocompatibility

Martínez-Miguel, Patricia; Sequera, Patricia de; Albalate, Marta; Medrano, Diana; Sánchez-Villanueva, Rafael; Molina, Álvaro; Sousa, F T de; Benito, Jesús; Nuñez, Jesús; Vozmediano, Carmen; Aragoncillo, Inés; Barril, Guillermina; Rodríguez‐Puyol, Diego; Pérez‐García, Rafael; López‐Ongil, Susana

doi:10.5301/ijao.5000380

Cited by 5 publications

(5 citation statements)

References 36 publications

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“…The percentages of proinflammatory monocytes in HD patients are higher than in patients with advanced CKD before the start of the technique (13) and are also higher than in PD patients (17). These findings have been attributed to the effects of the HD technique and, in this regard, a decrease of proinflammatory monocytes has been outlined including biocompatible membranes (18), with the HDF technique (19)(20)(21) and with use of drugs such as losartan, an angiotensin II receptor antagonist (22). However, given our results, this finding can also be explained by the presence of RRF, which is more common in CKD and not so in dialysis, and also usually in PD patients, even though Heine et al (17) do not include this parameter in their work.…”

Section: Discussionmentioning

confidence: 95%

Residual Renal Function in Hemodialysis and Inflammation

et al. 2017

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Residual renal function (RRF) has an important effect on uremic toxin clearance, on volume control, on quality of life, and on mortality. In patients with chronic kidney disease (CKD), microinflammation with an increased percentage of CD14 /CD16 inflammatory monocytes has been reported, even with no clinical evidence of inflammation. No correlation has been established between these and RRF in hemodialysis (HD) patients. Our objective was to assess the relationship between RRF and the inflammatory parameters in HD patients. Cross-sectional observational study was carried out on 69 adult patients on chronic HD for at least 6 months, from which demographic, analytic and HD-technique data were collected and the following were measured: (i) RRF with average urea and creatinine clearance ((CCr + CU)/2) in 24-h urine (if >1 mL/min and diuresis >100 mL/day, RRF was considered); (ii) Inflammation through biochemical parameters (C-reactive protein, β microglobulin, albumin) and monocyte subpopulations in peripheral blood. The average age was 70.9 [40-88] years old; 38 (55.1%) were male; and 25 (36.2%) were diabetic. 43.5% (30/69) presented RRF, with an average of ((CCr + CU)/2): 1.8 (2.6) mL/min and diuresis: 454.5 (569) mL /24 h. Patients with RRF presented lower concentrations of C-reactive protein (6.2 vs 21.4 mg/L) (P = 0.038) and a lower percentage of non-classical CD14 /CD16 monocytes (14.6 vs. 28.3%, P = 0.02). In our study, patients with RRF present lower concentrations of inflammatory parameters, which is another reason why its preservation is an essential objective in HD.

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Section: Discussionmentioning

confidence: 95%

Residual Renal Function in Hemodialysis and Inflammation

et al. 2017

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“…Since it has been clear that the effects of uremia on DCs are detrimental (2036), several therapeutic interventions have been proposed to prevent or at least limit uremiarelated cellular and/or biological alterations of immunologic cells, such as the use of biocompatible HD membranes and the introduction of hemofiltration (44454647). In addition, it has been suggested that improving HD clearance using a highly efficient dialyzer has the potential to improve the immunologic dysfunction in patients with ESRD.…”

Section: Modulation Of DC Function In Patients With Esrdmentioning

confidence: 99%

Dendritic Cell Dysfunction in Patients with End-stage Renal Disease

Kim

et al. 2017

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End-stage renal disease (ESRD) with immune disorder involves complex interactions between the innate and adaptive immune responses. ESRD is associated with various alterations in immune function such as a reduction in polymorphonuclear leukocyte bactericidal activity, a suppression of lymphocyte proliferative response to stimuli, and a malfunction of cell-mediated immunity at the molecular level. ESRD also increases patients' propensity for infections and malignancies as well as causing a diminished response to vaccination. Several factors influence the immunodeficiency in patients with ESRD, including uremic toxins, malnutrition, chronic inflammation, and the therapeutic dialysis modality. The alteration of T-cell function in ESRD has been considered to be a major factor underlying the impaired adaptive cellular immunity in these patients. However, cumulative evidence has suggested that the immune defect in ESRD can be caused by an Ag-presenting dendritic cell (DC) dysfunction in addition to a T-cell defect. It has been reported that ESRD has a deleterious effect on DCs both in terms of their number and function, although the precise mechanism by which DC function becomes altered in these patients is unclear. In this review, we discuss the effects of ESRD on the number and function of DCs and propose a possible molecular mechanism for DC dysfunction. We also address therapeutic approaches to improve immune function by optimally activating DCs in patients with ESRD.

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“…Biomaterial implants and medical devices are widely used today and their performance is crucial for the safety of patients and their quality of life (1). Nevertheless, the implantation of any foreign material or device will trigger a cascade of inflammatory responses, which can lead to chronic inflammation and fibrotic encapsulation, resulting in the failure of implants and devices (2).…”

Section: Introductionmentioning

confidence: 99%