Department of Nephrology, Beijing Friendship Hospital affiliated of Capital Medical University, Beijing, PR China.
Ren Fail. 2011;33(7):682-91. doi: 10.3109/0886022X.2011.589943.
Following the introduction of modified cellulosic and then synthetic membrane dialyzers, it was realized that the dialyzer bio-incompatibility depends on the membrane composition. We designed a prospective, randomized, cohort study of 6 months to determine several parameters of biocompatibility in maintenance hemodialysis (MHD) patients treated with four different membrane dialyzers.
There were 60 MHD patients enrolled in the study. In baseline, synthetic low-flux dialyzer, polysulfone (PS) membrane was used in all patients for at least 3 months. Then the patients were randomly divided into three groups according to different dialyzer membranes. Synthetic high-flux dialyzer group, polyethersulfone membrane, cellulose triacetate (CTA) high-flux membrane, and synthetic low-flux dialyzer, polymethylmethacrylate (PMMA) membrane were used in 6 months. A new dialyzer was used for each study treatment, and there was no dialyzer reuse. The biocompatibility markers and solutes removal markers were detected repeatedly at different time points.
The blood levels of highly sensitive C reactive protein, interleukin (IL)-1β, and interleukin (IL)-13 showed no difference among different groups at al time points. However, the blood complement levels and white blood cell counts were significantly different among three groups. When the dialyzers changed from PS to PMMA membrane, C3a levels and white blood cell counts changed significantly (p < 0.05). Moreover, the changes of C5a levels were significantly different between group CTA and group PMMA in month 3 (p < 0.05).
There were much more differences on bio-incompatibility among different dialyzer membranes.
在引入改良的纤维素和合成膜透析器之后，人们意识到透析器的生物不相容性取决于膜的组成。我们设计了一项前瞻性、随机、队列研究，为期 6 个月，以确定在接受四种不同膜透析器治疗的维持性血液透析（MHD）患者中，生物相容性的几个参数。
共有 60 名 MHD 患者入组本研究。在基线时，所有患者均使用合成低通量透析器、聚砜（PS）膜至少 3 个月。然后，根据不同的透析器膜将患者随机分为三组。在 6 个月的时间里，使用合成高通量透析器、聚醚砜膜、三醋酸纤维素（CTA）高通量膜和合成低通量透析器、聚甲基丙烯酸甲酯（PMMA）膜。每种研究治疗均使用新的透析器，且无透析器复用。在不同时间点反复检测生物相容性标志物和溶质清除标志物。
在所有时间点，不同组之间的高敏 C 反应蛋白、白细胞介素（IL）-1β和白细胞介素（IL）-13的血液水平均无差异。然而，三组之间的补体水平和白细胞计数有显著差异。当透析器从 PS 膜变为 PMMA 膜时，C3a 水平和白细胞计数发生显著变化（p<0.05）。此外，在第 3 个月时，CTA 组和 PMMA 组之间 C5a 水平的变化有显著差异（p<0.05）。
不同透析器膜之间的生物不相容性差异较大。
