INTRADIALYTIC GRANULOCYTE REACTIVE OXYGEN SPECIES PRODUCTION - A PROSPECTIVE, CROSSOVER TRIAL

By the use of flow cytometric techniques, this prospective, randomized crossover study was designed to analyze intradialytic granulocyte rea ctive oxygen species (ROS) formation in whole blood with complement-ac tivating and noncomplement-activating hollow fiber membranes. Dialysis with a complement-activating membrane resulted in a 6.5-fold increase in granulocyte hydrogen peroxide production 15 min after dialysis ini tiation and remained significantly elevated (P < 0.01) through the fir st 30 min with this membrane in comparison to both predialysis values and simultaneous values with a noncomplement-activating membrane. Furt her studies demonstrated that blood obtained at 15 min with a compleme nt-activating membrane generated significantly less granulocyte ROS pr oduction in response to Staphylococcus aureus incubation than blood ob tained either predialysis or at the same time in dialysis with a nonco mplement-activating membrane. Both complement-activating and noncomple ment-activating dialysis membranes caused slightly decreased granulocy te responsiveness to phorbol myristate acetate. It was concluded that hemodialysis with complement-activating membranes results in increased granulocyte ROS production and decreased responsiveness to S. aureus challenge during the dialysis procedure. These results document the po tential role of ROS in hemodialysis-associated pathology and susceptib ility to infection.