Electrical current leakage during hemodialysis may increase blood-membraneinteraction

During hemodialysis blood - membrane interaction causes complement activati on. During dialysis there may be an electrical current leakage to the dialy zer, especially if there is a broken ground or a defect in another electric al device coupled to the patient. This study investigated whether an electr ic current of 1.5 mA DC could alter blood membrane interaction as measured by changes in C3d in the blood. Such a high current leakage could occur bec ause there is no protection in the dialysis machine (Class 1B) against auxi liary current leakage. Such a current could come from a defective external device in contact with the patient during hemodialysis. Materials: A dialysis machine (Fresenius 2008C) with a filled blood-line sy stem containing about 350 mi whole blood from each of 8 different donors wa s used in vitro. Each of the eight test-runs also contained 1000 U added he parin. The dialysis procedure was performed using hemophan membranes (GFS 12, Gambro) with bicarbonate and potassium 3.0 (D210, Gambro) as dialysate. Two electric poles were placed in the blood line, before and after the dia lyzer (connected in parallel) and the ground was placed at entry and exit o f the dialysate fluid coming from the machine to the dialysis filter C3d wa s measured before the start of "dialysis" and at 15, 30, 45 and 60 min, dur ing dialysis. Thereafter the 1.5 mA current was switched on and additional samples were drawn at 75 and 90 min. The mean C3d values were calculated Pa ired non-parametric statistical analyses were performed. Results: There was a significant and continuous increase in C3d as compared to the "predialysis" level. The increase during 0 to 30 minutes was greate r than that from 30 to 60 minutes (p=0.018); the increase in C3d during 60 to 90 min, was greater than that from 30 to 60 min (p=0.018) and there was no difference between the 0 to 30 and the 60 to 90 min increases. Conclusions: A current, used in this study, was able to induce a blood memb rane interaction during in vitro dialysis. Even a weaker current leakage mi ght have such adverse effects and similar interactions seem possible during regular dialysis depending on the extent of the leakage.