Haemodialysis-triggered asthma.

Aljama, Pedro; Brown, Peter H.; Turner, P; Ward, M. K.; Kerr, David

doi:10.1136/bmj.2.6132.251

Cited by 26 publications

(4 citation statements)

References 1 publication

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“…Thus polyacrylonitrile membranes have been shown to cause reduc tion in complement function without signifi cant leukopenia, and polycarbonate mem branes to induce leukopenia without detect able decline in complement fractions [11], Furthermore, leukopenia and hypoxemia have been claimed to be unrelated effects of hemodialysis [ 12], However, De Backer et al [13] showed that biocompatibility of the dialyzer used, as estimated by the degree of leu kopenia induced, is a significant contributing factor to hemodialysis hypoxemia. In a pre vious investigation we found that RC mem branes induced greater degrees of leukopenia, activation of complement, generation of C5a and dialysis hypoxemia than did CA mem branes [unpubl.…”

Section: Discussionmentioning

confidence: 99%

Leukopenia and Release of Granulocyte Elastase: Interlinked Membrane-Dependent Events during Hemodialysis

Knudsen¹,

Nielsen²,

Pedersen³

1984

Blood Purif

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In order to investigate the effect of dialyzer membrane material on hemodialysis-induced leukopenia and release of granulocyte elastase, 12 patients were studied during two successive dialyses using membranes based on regenerated cellulose (RC) and cellulose acetate (CA). RC membranes induced greater and more prolonged leukopenia than did CA membranes. Release of granulocyte elastase, assessed as changes in plasma levels of elastase in complex with α₁-proteinase inhibitor (E-α₁-PI), increased with both membranes, but significantly more with RC membranes. The demonstrated liberation of granulocyte elastase could contribute to the deterioration of pulmonary function reported during hemodialysis. Furthermore, we suggest that measurement of E-α₁-PI may be used to evaluate biocompatibility of dialyzer membranes.

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Section: Discussionmentioning

confidence: 99%

Leukopenia and Release of Granulocyte Elastase: Interlinked Membrane-Dependent Events during Hemodialysis

Knudsen¹,

Nielsen²,

Pedersen³

1984

Blood Purif

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“…Several hemodialysis-associated allergic reactions were observed in renal failure patients [7,8], Recently, a case with asthma triggered by hemodialysis was reported by Aljama et al [5], The role of cuprophane in activating complements in the membrane was postulated [6], Some provocation tests and the dramatic effect of the dialysis by the acetate-free dialysate suggests a direct re- lation of acetate to the asthma in the present case. Heparin or ethylenedioxide gas was shown to be noneflective in relieving the attacks [7,9], The action of acetate ion on the pulmonary vascular beds or respiratory tracts is unknown.…”

Section: Discussionmentioning

confidence: 84%

“…Recently, A!jama et al [5] reported a case of hemodialysis-triggered asthma. A role of complements activated by dialyser mem brane was postulated to trigger the attack [6], This report is concerned with a case of asthma which was related to acetate used in the dialysate.…”

mentioning

confidence: 99%

Hemodialysis-Associated Asthma in a Renal Failure Patient

Ei¹,

Hanai²,

Horiuchi³

et al. 1980

Nephron

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In a renal failure patient, asthma developed after 1 year hemodialytic treatment. The attack was exclusively associated with each hemodialysis. Skin test to the usual allergen such as house dusts or pollens was negative. The provocation test by inhaling acetate solution or oral intake of acetic acid was positive resulting in an increase in the pulmonary resistance, or asthmatic attack. This asthma disappeared completely after substitution of acetate in the hemodialysis by the use of a bicarbonate dialysate. Acetate might therefore precipitate the attack of asthma.

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“…The observation that occasional patients develop asthmatic symptoms during haemo dialysis [5] has focussed interest on changes in airway function. Recent studies from this unit reported small but significant falls in peak expiratory flow rate in most patients undergoing haemodialysis for chronic renal failure [6], especially in those using a new cuprophane dialyser [7], The mechanisms of these changes in airway function are un known.…”

Section: Introductionmentioning

confidence: 99%

Bronchial Reactivity in Patients Undergoing Long-Term Haemodialysis for Chronic Renal Failure

Walshaw¹,

Lim²,

Ahmad³

et al. 1991

Blood Purif

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Trapping of neutrophils within the lung occurs in patients undergoing haemodialysis and is also a possible mechanism in the pathogenesis of bronchial hyper-responsiveness. Falls in peak expiratory flow rate occur in most dialysis patients, and some develop overt asthmatic symptoms. To see whether these changes in airway function are secondary to increases in bronchial reactivity during haemodialysis, we therefore performed histamine challenge testing in 6 non-asthmatic patients before and after haemodialysis. No change in reactivity was observed, suggesting that haemodialysis does not commonly result in bronchial hyper-reactivity in non-asthmatic individuals.

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Haemodialysis-triggered asthma.

Cited by 26 publications

References 1 publication

Leukopenia and Release of Granulocyte Elastase: Interlinked Membrane-Dependent Events during Hemodialysis

Leukopenia and Release of Granulocyte Elastase: Interlinked Membrane-Dependent Events during Hemodialysis

Hemodialysis-Associated Asthma in a Renal Failure Patient

Bronchial Reactivity in Patients Undergoing Long-Term Haemodialysis for Chronic Renal Failure

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