BIOKOMPATIBILNOST HEMODIJALIZNIH MEMBRANA U RAZLIČITIM DIJALITIČKIM METODAMA.

The contact of blood with dialysis membranes elicits organized inflammatory response, especially complement activation via alternate pathway and leucopenia. The inflammatory response leads to numerous longterm clinical sequels, which are in part determined by the degree of the membrane biocompatibility. The aim of this study is to analyze the biocompatibility of different dialysis modalities in our patients. Our survey included 42 patients, divided in four groups based on the hemodialysis treatments. I -group - bicarbonate hemodialysis on a low-flux polysulfone membrane (N -10) II-group - bicarbonate hemodialysis on a high-flux polysulfone membrane (N -12) III -group postdilution on-line hemodiafiltration (l\l -10) IV -group - bicarbonate hemodialysis on cuprofan membrane (N -10). Biocompatibility is assessed based on the reduction of leukocyte count in first 15 minutes of hemodialysis, activation of complement components (C3 and C4) which were determined at the beginning of hemodialysis, after 30 min, 180 minutes, 240 minutes. The survey included 42 patients: 22 males and 20 females mean age 51.4±7.6 and mean hemodialysis duration of 54 months. In the first 15 minutes the leukocyte count decreased by 14.47±8,35% in group I; by I2.43±9.45% in group II; by 10.54±6.36% in group III and by 45.42+15.31% in group IV. The decrease of the leukocyte count was significantly higher in group four (cuprophan), compared to other three groups (p<0.001). Opposite to the number of leukocytes, activation of complement components was at its peak when the leukocyte count had been lowest. In first three groups there was no statistically significant difference in complement components' values. Group I C3 O.88±0.25g/L, C4 0.61 ±0.43g/L, group II C3 0.68±0.16g/L, C4 0.4±0.15g/L, and group III C3 0.53±0.13g/L, C4 0.26±0.08g/L. In the fourth group there was a significant increase in complement components values at the end of hemodialysis C3 1.26±0.43g/L,C4 0.75±0.57g/L(p<0.05). The use of on-line hemodiafiltration and high-flux dialysis provides higher degree of biocompatibility than cuprofan dialysis. It is based on the use of synthetic dialysis membranes and ultra pure dialysis fluid. [ABSTRACT FROM AUTHOR]