BIOCOMPATIBLE MEMBRANES PRESERVE RESIDUAL RENAL-FUNCTION IN PATIENTS UNDERGOING REGULAR HEMODIALYSIS

Initiation of hemodialysis causes a further decrease of residual renal function (RRF), To assess the impact of the biocompatibility of the d ialysis membrane, we performed a prospective randomized investigation in 20 normotensive patients with tubulointerstitial nephritis, The pat ients were randomly allocated to treatment with either a high-flux pol ysulfone or cellulose membrane over a period of 12 months. RRF, define d by creatinine clearance and daily urine volume, was found to decreas e in both groups of patients after the initiation of hemodialysis, Of the two membranes used, however, the cellulose membrane caused an acce lerated decrease of RRF (P < 0.05). The better maintenance of RRF in p atients treated with polysulfone membranes was associated with higher Kt/V values and increased hematocrit values (P < 0.05), The pathophysi ologic mechanism underlying the more rapid decline of RRF could not be explained by intradialytic hypotension, but may be related to the nep hrotoxic effects of inflammatory mediators due to bioincompatibility. Therefore, the use of polysulfone membranes might be preferable in pat ients with relevant RRF. (C) 1997 by the National Kidney Foundation, I nc.