BIOCOMPATIBILITY OF HEMODIALYSIS MEMBRANES - HEMODIALYSIS-RELATED LEUKOTRIENE B-4 AND C-4 GENERATION

The aim of our study was (1) to verify whether haemodialysis (HD) with cuprophane (CUP) and polyacrylonitrile (PAN) membranes is associated with the release of vasoactive leukotriene (LT) C-4 and chemotactic LT B(4) and (2) to analyse the respective roles of lipoxygenase and cyclo -oxygenase metabolites of arachidonic acid in membrane bio-incompatibi lity. The investigation was performed in 10 uremic patients using holl ow-fibre dialysers and dialysed successively, in random order, with CU P and PAN membranes. The arterial and venous (from dialyser) blood was sampled for the measurement of biochemical parameters, plasma LTC(4), LTB(4) and prostaglandins (PG) 6-keto-F-1 alpha, E(2), F-2 alpha and thromboxane B-2 before and after 15, 30 and 240 min of HD. Eicosanoids were measured by RIA after prior extraction and HPLC separation. Resu lts: CUP HD was associated with a marked early leukopenia and a delaye d decrease in blood pO(2). Simultaneously, plasma LTB(4) and LTC(4) in creased significantly in arterial blood after 30 min of HD and in veno us blood at the end of session of 240 min. Cyclo-oxygenase metabolites increased as well, but nonsignificantly, with a maximum at the end of HD. PAN HD did not significantly change white blood cell count, pO(2) or plasma eicosanoid levels. Conclusion: CUP membranes stimulate the release of proinflammatory and vasoactive LTB(4) and LTC(4). PAN membr ane haemodialysis is without such side effects. The release of LTs may be an additional valuable marker of membrane bioincompatibility.