Abstract
Anticoagulant activity of FUT has been reported to be eliminated during hemodialysis (HD) with AN69 dialyser (PAN membrane, HOSPAL). This disadvantage was speculated to be due to adsorption of EDT by AN69. We compared the adsorption and anticoagulant activity of FUT between AN69 and DX (PAN membrane, ASAHI MEDICAL), which contains carboxyl group in contrast to sulfonate group in AN69, in vitro and in HD patients. Saline including FUT (40mg/l) was poured into mini-module(100cm2) of AN69 and DX at a rate of 2ml/min, and the concentrations of FUT at the outlet of these modules were measured. During HD with FUT(20mg/l of FUT was included in saline at the priming, and infused at a rate of 40mg/hr), EDT, amidinonaphthol (AN) and paraguanidinobenzoic acid (PGBA) which are resolved metabolites of EDT by plasma esterase activity, were determined in plasma entering and leaving these dialysers, and in dialysates. As results in vitro, more than 75% of FUT was adsorbed by AN69 during 3 hrs, although DX was saturated with FUT within 30min, FUT, AN and PGBA concentrations in plasma and dialysate at any point during HD were significantly higher than those with AN69. The number of fibers with clotted filaments reached more than 3% in AN69 dialyser, although no clotted filament was observed in DX. In conclusion, a large part of infused FUT was adsorped and isolated from plasma, and its anticoagulant activity was eliminated in HD with AN69, but not in HD with DX. This fault of AN69 was suspected to be due to combination of its sulfonate group and FUT.
