STUDY OF SOME ACUTE BIOCOMPATIBILITY REACTIIONS IN HEMODIALYSIS WITH DIFFERENT MEMBRANES AND THE EFFECT OF REUSE

Abstract

During hemodialysis blood membrane contact results in humoral and cellular reactions. These adverse reactions are termed bioincompatibility reactions. Several types of dialyzer membranes exist and vary in their bi0incompatibility. These membranes of dialyzers are the major element of cost in dialysis procedures. To reduce the cost of dialysis, dialyzer reuse was adapted in many countries. The multiple use of dialyzers was supposed to alternate the reactions due to bioincompatibility seen with first used membranes. The aim of this work was to study some of the acute bioincompatibility reactions with the use of three different membranes; unsubstituted cellulose ( cuprophane), synthetically modified cellulose (homophan), and synthetic membranes (polysulfone), and to find the impact of reuse on the dialyzer performance and the extent of the bioincompatibility reactions using both acetate and bicarbonate dialysate. The study was carried out on 20 end-stage renal disease patients on regular hemodialysis for at least 6 months prior to the star; of the study. 20 healthy subjects were taken as controls for measuring Complement,C3 and C4, IL-1 3, TNF- a, and neutrophil elastase. Patients suffering from acute intercurrent infections, fever, chronic infections, immune suppressive disorders, collagenic diseases, liver diseases, or receiving immune-suppressive drugs or anti-platelet drugs were excluded from the study. Patients participating in the study were subjected to hemodialysis by first used and reused three different membranes each for three consecutive sessions. Laboratory tests were done in the third session after the long inter dialytic period for each of the studied first used and reused membranes with acetate and bicarbonate.