Effect of hemodialysis on the serum levels of activated complements and neutrophil elastase, and oxygenation in the lung in patients of acute renal failure

Abstract

Comparative effects of three different membranes (cuprophan, ethylenevinylalcohol (EVAL), polyethylmethacrylate (PMMA)) on the serum levels of complements (C3a, C4a and C5a) and neutrophil elastase, neutrophil counts and oxygenation in the lung were studied in patients with multiple organ failure during hemodialysis.
A cuprophan membrane decreased neutrophil counts 20min. after the initiation of hemodialysis. On a complement system, both cuprophan and EVAL membrane increased serum levels of C3a and C5a. With a cuprophan membrane, the level of neutrophil elastase increased significantly 60min., 120min. after hemodialysis began. Respiratory Index (RI) rose slightly 40min. after the start of hemodialysis only when a PMMA membrane was used.
Although there was no significant difference with regard to RI among three membranes, it should be advised to select a PMMA membrane, considering the other two membranes caused leukocytopenia, activation of complements and elevation of neutrophil elastase.