COMPLEMENT ACTIVATION IS INFLUENCED BY THE MEMBRANE MATERIAL, DESIGN OF THE DIALYZER, STERILIZING METHOD, AND TYPE OF DIALYSATE

The complement system becomes activated during blood-membrane contact in the dialyser. This study was designed to evaluate to what extent th e dialyser design, the sterilization method, and the type of dialysate influence complement as measured by C3d. Twelve patients were dialyse d three times on each of four different dialysers. Two hollow-fibre di alysers made of cuprophane (Hf-CuE ethylene-oxide-sterilized, Hf-CuS s team-sterilized) were compared with two plate dialysers made of cuprop hane (P-Cu) or polycarbonate (P-Pc). Five patients were dialysed with acetate and seven with bicarbonate. Differences in C3d between at star t of dialysis and after 180 min were calculated. C3d was increased mor e by P-Cu than by the other dialysers (P < 0.012, n = 12). In the bica rbonate group, C3d was increased more by P-Cu than by Hf-CuS or P-Pc ( P < 0.022, n = 7) and more by Hf-CuE than Hf-CuS (P = 0.013). In the a cetate group, C3d was increased more by Hf-CuS and P-Cu than by P-Pc ( P < 0.006, n = 5). In conclusion, complement activation during dialysi s varied due to membrane material, membrane design, sterilization meth od, and dialysate composition.