Abstract
The kinetics of coagulation factors and platelet factors during hemodialysis with different dialysis membrane materials and anticoagulants was investigated. The anticoagulants used for this study inclued heparin, low molecular weight heparin (LMWH), and nafamostat mesilate (NM). The membrane materials were Cuprophan, EVAL, PMMA and Hemophan. For EVAL membrane dialyzer, non-anticoagulant hemodialysis was conducted as a control, same kinetics with different anticoagulants was investigated. Heparin slightly suppressed the activity of factors XII and XI while LMWH suppressed the activity of the factor VIII. NM inhibited the solid phase reaction and the activity of factor VIII, and showed a clear suppressive effect on platelet activity compared with both types of heparin. Conceming the membrane materials, there were differences found in the activities of factor VIII, anti-factor X a and platelet factor-4 especially when heparin or LMWH was used an anticoagulant. We suspect that both types of heparin adsorption to Hemoplan and high thrombogenicity of PMMA probably reflected the antithrombotic effect in hemodialysis. Anticoagulants must be used considering the characteristics of membrane materials.
