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 reactive oxygen species (ROS) formation in whole blood with complement-activating and noncomplement-activating hollow fiber membranes. Dialysis with a complement-a...

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Bibliographic Details
Published in:Journal of the American Society of Nephrology 1993-08, Vol.4 (2), p.178-186
Main Authors: Himmelfarb, J, Ault, K A, Holbrook, D, Leeber, D A, Hakim, R M
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Cellulose - adverse effects
Cellulose - analogs & derivatives
Complement Activation
Disease Susceptibility - etiology
Endothelium, Vascular - pathology
Female
Flow Cytometry
Granulocytes - drug effects
Granulocytes - metabolism
Humans
Infections - etiology
Male
Membranes, Artificial
Methylmethacrylates - adverse effects
Middle Aged
Prospective Studies
Reactive Oxygen Species - metabolism
Renal Dialysis - instrumentation
Respiratory Burst
Staphylococcus aureus
Tetradecanoylphorbol Acetate
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Summary:By the use of flow cytometric techniques, this prospective, randomized crossover study was designed to analyze intradialytic granulocyte reactive oxygen species (ROS) formation in whole blood with complement-activating 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 initiation and remained significantly elevated (P < 0.01) through the first 30 min with this membrane in comparison to both predialysis values and simultaneous values with a noncomplement-activating membrane. Further studies demonstrated that blood obtained at 15 min with a complement-activating membrane generated significantly less granulocyte ROS production in response to Staphylococcus aureus incubation than blood obtained either predialysis or at the same time in dialysis with a noncomplement-activating membrane. Both complement-activating and noncomplement-activating dialysis membranes caused slightly decreased granulocyte 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 potential role of ROS in hemodialysis-associated pathology and susceptibility to infection.
ISSN:1046-6673
DOI:10.1681/asn.v42178