Nr. Skroeder et al., INDIVIDUAL-DIFFERENCES IN BIOCOMPATIBILITY RESPONSES TO HEMODIALYSIS, International journal of artificial organs, 17(10), 1994, pp. 521-530
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.