| ObjectiveHemodialysis, as the effective treatment of end stage renal disease, is now considered as the most effective therapy for patients with uremia. Because uremic patients are often associated with severe immune dysfunction and HD can not change this situation, and immune dysfunction of patients may also be increased to some extent by the pros and cons of dialysis membrane biocompatibility, it leads to a series of urgent or chronic inflammatory response. Therefore, understanding the effects of dialysis membrane on the immune function of HD patients is an important part, which is used to evaluate the biocompatibility of dialyzer. Compared with the cellulose membrane, synthetic membranes such as polysulphone membrane can effectively prevent the passage of pyrogen. This study is used to evaluate the effect of low-flux polysulphone membranes on serum levels of IL-1β, IL-6, C-reactive protein, complement C3, C4, neutrophils, monocytes, and platelets in hemodialysis patients.MethodsWe choose 24 cases of long-term hemodialysis from Shenyang Fifth People's Hospital during March 2010～May 2010, including 11 males and 13 females. Candidate criteria:(1) stable disease, dialysis for at least 6 months; (2) No chronic infection, tumor, severe liver disease, autoimmune disease activities; (3) nearly half year did not receive blood transfusion, not using immunosuppressive drugs; (4) the use of bicarbonate dialysate composition (Na+ 140mmo 1/L, K+ 2 mmol/L.HCO3- 32 mmol /L, glucose 0 mmol/L), dialysis fistula blood flow≥200 ml/min, dialysate flow 500ml/min, anticoagulation stability,2 times a week hemodialysis, each dialysis time 4 h; (5) had been using low-flux polysulphone membrane (model F7HPS, membrane area of 1.6m2, the German company Fresenius) for the hemodialysis; (6) signed informed consent. On the test day, before the hemodialysis, we collected 8ml venous blood with 3 tubes. At the end of hemodialysis, before the the reinfusion of normal saline, we also collected 8ml arterial blood with 3 tubes. (One is 2ml for the blood routine; two is 3ml for the biochemical test.) the blood routine tube was inspected immediately, the other two were saved for test under 70℃. Differences of serum levels of IL-1β, IL-6, C-reactive protein, complement C3, C4, neutrophils, monocytes, and platelets were assessed by paired t test, P<0.05 for the difference was statistically significant.ResultsThe serum levels of IL-1β, IL-6 before and after dialysis were (38.08±10.50),(37.92±11.53)pg/mL and (29.97±15.96),(29.32±15.82)pg/mL, P>0.05 for the difference was not statistically significant. The serum levels of C-reactive protein, complement C3, C4 before and after dialysis were (4.52±3.28),(4.57±3.46)mg/L, (0.907±0.151),(0.915±0.171)mg/L and (0.279±0.048),(0.281±0.071)mg/L, P >0.05 for the difference was not statistically significant. The serum levels of neutrophils, monocytes, and platelets before and after dialysis were (4.47±1.77) (4.44±1.60)×109/L,(0.402±0.193),(0.381±0.213)×109/L and (190.8±60.5) (193.3±62.1)×109/L,, P>0.05 for the difference was not statistically significant.ConclusionLow-flux polysulphone membrane has no effects on serum levels of IL-1β, IL-6, CRP, complement C3,C4, neutrophils, monocytes platelets during one session in hemodialysis patients. It concludes that Low-flux polysulphone membrane has smaller activation for complement, neutrophils, and monocytes, and low-flux polysulphone little effects on the blood coagulation. It shows that the coagulation disorder of long-term hemodialysis patients with uremia, may be associated with the biocompatibility of the dialysis membrane, It concludes that the material of dialysis membrane may affect the blood levels of inflammatory cytokines in dialysis process, suggests that it may reduce the inflammatory response in the dialysis process as well as other.
|
PDF Full Text Request