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Biocompatibility of Hemodialysis

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Trends in Biomedical Research

Part of the book series: Advances in Experimental Medicine and Biology ((CLEXBI,volume 1251))

Abstract

This study was designed to investigate the biocompatibility of hemodialysis procedures, largely depending on the contact of patient’s blood with the dialysis membranes. We addressed the issue by comparing the content of the proteolytic enzymes collagenase and cathepsin B and that of neutrophil myeloperoxidase (MPO) and C-reactive protein (CRP) in the blood before and after a single session treatment and a full course of successive 8-week-long therapies with three types of hemodialysis: low-flux (lfHD), high-flux (hfHD), and post-dilution hemodiafiltration (HDF). The study included 19 patients with chronic nephropathy. We found that collagenase significantly increased after a single session of each type of hemodialysis. Cathepsin B tended to decrease after single sessions; the decrease reached significance only after hfHD. CRP increased significantly after single hfHD and HDF treatments. These changes were meager, with no differences depending on the dialysis type, and their significance was lost after 8-week-long therapy, except the persisting increase in CRP after HDF. Neutrophil MPO apparently was not activated during any type of dialysis, as its content was below the detection threshold. We conclude that all three types of hemodialysis are compatible with the biological system, so that they would rather unlikely lead to clinically harmful effects in chronically hemodialyzed patients. Nonetheless, proteolytic enzymes and myeloperoxidase seem hardly appropriable estimators of hemodialysis biocompatibility due to meager and variable changes. Upregulation of C-reactive protein, on the other hand, expresses a general pro-inflammatory propensity of hemodialysis and is not a suitable estimator of biocompatibility either.

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Acknowledgments

Funded by a grant no 258 from the Military Institute of Medicine.

Conflicts of Interest

The authors declare no conflict of interest in relations to this article.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the Bioethics Committee of the Military Institute of Medicine in Warsaw, Poland – 05-2013.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Authors and Affiliations

  1. Department of Internal Medicine, Nephrology and Dialysis, Military Institute of Medicine, Warsaw, Poland

    Małgorzata Gomółka, Magdalena Mossakowska, Jerzy Smoszna, Aleksandra Rymarz & Stanisław Niemczyk

  2. Department of Nephrology, Dialysis and Internal Medicine, Medical University of Warsaw, Warsaw, Poland

    Longin Niemczyk

  3. Department of Epidemiology and Biostatistics, Institute of Mother and Child in Warsaw, Warsaw, Poland

    Katarzyna Szamotulska

  4. Department of Immunology, Transplantology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland

    Leszek Pączek

Authors
  1. Małgorzata Gomółka
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  2. Longin Niemczyk
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  3. Katarzyna Szamotulska
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  4. Magdalena Mossakowska
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  5. Jerzy Smoszna
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  6. Aleksandra Rymarz
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  7. Leszek Pączek
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  8. Stanisław Niemczyk
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Corresponding author

Correspondence to Longin Niemczyk .

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Editors and Affiliations

  1. Opole Medical School, Opole, Poland

    Mieczyslaw Pokorski

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Gomółka, M. et al. (2019). Biocompatibility of Hemodialysis. In: Pokorski, M. (eds) Trends in Biomedical Research. Advances in Experimental Medicine and Biology(), vol 1251. Springer, Cham. https://doi.org/10.1007/5584_2019_461

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