Clinical performance of a new high-flux synthetic membrane

The clinical performance during first use of a new membrane manufactured fr om a blend of polyarylethersulfone and polyvinylpyrrolidone (Arylane; Hospa l Renal Care, Lyon, France), in which the microstructure of the membrane ha s been tailored by the manufacturing process and polymer blend, has been co mpared with Fresenius Polysulfone (Fresenius Medical Care, Bad Homburg, Ger many) in a prospective, randomized, crossover study. Small-molecular cleara nces were similar. A reduction in plasma beta(2)-microglobulin levels was p resent using both membranes, with a significantly greater removal by Arylan e such that the mean postdialysis plasma level difference between the membr anes at the end of dialysis was 8.7 mg/L (95% confidence interval, 3.9 to 1 3.5; P = 0.004), Recovery of beta(2)-microglobulin from the dialysis fluid was similar: 170 +/- 70 mg for Arylane and 110 +/- 60 mg for Fresenius Poly sulfone (P = 0.04), Both membranes were impermeable to albumin but allowed the passage of low-molecular-weight proteins, with 10,046 +/- 3,239 mg for Arylane and 7,285 +/- 2,353 mg for Fresenius Polysulfone recovered from the dialysis fluid (P = 0.07). Neutropenia and platelet adhesion to the membra ne were minimal, and time-averaged complement levels during dialysis for C3 a and C5b-9 were 207 +/- 92 and 62 +/- 24 ng/mL for Arylane and 223 +/- 68 and 45 +/- 24 ng/mL for Fresenius Polysulfone, respectively, and were membr ane independent. This study indicates that the membrane using polyarylether sulfone in conjunction with PVP has complement-activation potential and neu tropenia similar to Fresenius Polysulfone but has an enhanced capacity to r emove beta(2)-microglobulin. This enhanced removal arises from transmembran e transport augmented by adsorption within the membrane matrix. (C) 2000 by the National Kidney Foundation, Inc.