Granulocyte activation during hemodialysis.

Plasma levels of granulocyte lactoferrin, myeloperoxidase, and elastase in complex with alpha 1-proteinase inhibitor (E-alpha 1PI) during hemodialysis were investigated in patients undergoing maintenance hemodialysis with dialyzers made from cellulose hydrate, polymethylmethacrylate, cuprophan, ethylene-vinyl alcohol copolymer, polycarbonate, polyacrylonitrile or polysulfone. Polymethylmethacrylate membrane caused markedly elevated plasma lactoferrin (712.5 +/- 165.9 ng/ml) and E-alpha 1PI (681.8 +/- 102.6 ng/ml). Lower levels were observed in patients dialyzed with cuprophan or polycarbonate dialyzers, while cellulose hydrate membrane caused a maximal increase of the E-alpha 1PI levels (1,6590 +/- 256.8 ng/ml). Polyacrylonitrile membrane provoked minimal E-alpha 1PI formation (267.6 +/- 79.6 ng/ml) but markedly elevated plasma levels of lactoferrin. However, polysulfone dialyzers displayed only very modest increases of the plasma E-alpha 1PI and lactoferrin levels. Plasma levels of myeloperoxidase were unchanged comparing the effects of the different dialyzers. We conclude that granulocyte activation during hemodialysis does not necessarily need anaphylatoxin formation.