Suppression of fever in a hemodialysis patient following dialysis membrane

analysis using heart rate variability spectrum

Abstract

A 56-year-old woman who had received a bone marrow transplant for acute leukemia began dialysis in May 2007. She immediately developed a fever during maintenance hemodialysis. The cause of fever was considered conventional polysulfone membrane, and after changing the dialysis membrane to an EK membrane, fever disappeared. The present study investigated the biocompatibility of several dialysis membranes based on heart rate variability analysis. High frequency (HF) and low frequency (LF) conponents, HF/LF and CVRR were analyzed using a Memcalct^® system, and clinical characteristics including pulse rate and body temperature were also assayed. The dialysis membrane was sequentially changed from EK to KF, RC,VEP, PEPA and VEP. The clinical characteristics and sympathetic nervous activity of HF decreased during HD using the VEP membrane, and parasympathetic nervous activities (HF, CVRR) increased using the VEP membrane. Sympathetic activity and parasympathetic activity showed reciprocal results. In this case , fever suppression was better with the VEP membrane than with the EVAL membrane. This was related to improvement of the biocompatibility of the inner-surface of the PS membrane, which is coated with vitamin E.