Clinical evaluation of a new high-flux cellulose acetate membrane.

One major goal of dialysis therapy has become the removal of beta 2-microglobulin (beta 2-m). The interdialytic elimination of beta 2-m was studied using a newly developed high-flux cellulose acetate (CA) membrane. The results show that high-flux CA dialyzers offer better biocompatibility than classical Cuprophan or high-flux Cuprophan devices, with regard to leukopenia, C3a desarg generation, and elastase release from polymorphonuclear (PMN) leukocytes. Compared to high-flux CA membranes, high-flux PMMA membranes induce less C3a desarg formation but comparable leukopenia. High-flux PMMA membranes, however cause greater leukocyte stimulation than CA as demonstrated by more PMN elastase release during hemodialysis. Using high-flux CA or high-flux PMMA membranes, serum beta 2-m levels decreased 32% during dialysis. Serum beta 2-m dropped 10% with high-flux Cuprophan membranes, but remained unchanged with conventional Cuprophan dialyzers. Sieving coefficients for beta 2-microglobulin (beta 2-m) were virtually zero with classical Cuprophan and 0.66 with high-flux cellulose acetate membranes. High-flux membranes made of Cuprophan and PMMA gave coefficients of 0.25 and 0.45, respectively. This indicates the high removal capacity of the new CA-membrane for substances with high molecular weight. This high-flux CA membrane thus appears to combine a good degree of biocompatibility with a high capacity for beta 2-m removal.