INDIVIDUAL-DIFFERENCES IN BIOCOMPATIBILITY RESPONSES TO HEMODIALYSIS

There are very few reports in the literature on individual differences in the response to dialysis treatment. We studied the influence of th e individual patient, dialysis membrane qualify, blood-flow (Qb) and s urface area on leukocyte activation and complement generation (C3a) du ring 234 hemodialysis treatments using Cuprophan (CU), hemophane (HE) and polyamide (PA) dialyzers. The most common reaction was a decrease in leukocyte count and an increase in C3a after 15 minutes of treatmen t. Leukocyte overshoot by the end of dialysis was observed at high Qb for all three membranes but at low Qb only during CU treatments. The r eaction,patterns were influenced by the quality of the membrane, area and Qb. Analysis of each individual patient showed for a large number of treatments reaction patterns corresponding to those described in th e literature. However, some patients reacted differently. In four pati ents (20%), the nadir in leukocyte count and maximum in C3a concentrat ion was reached considerably later during CU-dialysis. Three patients were devoid of pronounced early leukocyte response but presented with the late overshoot during CU-dialysis. Three other patients reacted wi th an early drop in leukocyte count and a rapid increase in C3a genera tion during PA treatments but not during HE treatments. Three other pa tients reacted vice versa. A particular mode of dialysis treatment may thus be biocompatible for some patients but not necessarily for all. In the case biocompatibility is desired the individual response to the particular dialysis mode needs to be identified The underlying mechan isms warrant further studies.