Abstract
In order to evaluate biocompatibility in hemodialysis, we measured three parameters; whole-blood activated coagulation time, APTT and fibrinopeptide A concentration determined by enzyme immunoassay in the extracorporeal circuit. Studies were performed on ten maintenance dialysis patients during a 4-h dialysis session, using two kinds of anticoagulant; heparin and synthetic antithrombin (MD 805). The effectiveness of anticoagulation was assessed by determination of fibrinopeptide A (FPA), which is a useful marker of thrombin activity on fibrinogen conversion. There was a linear correlation between FPA production in the dialyzer and the FPA concentration of blood in the arterial line to the dialyzer in both anticoagulant sessions. Higher production of FPA was noted at 60min after the start of hemodialysis when continuous infusion at 0.3mg/kg/h of MD 805 was employed. Although the anticoagulant activity was essentially the same for the two anticoagulants, the discrepancy in FPA production between the two anticoagulants was thought to be because of their different interaction on the artificial membrane. The biocompatibility of the extracorporeal circuit by determination of FPA production may be influenced by pharmacological characteristics preventing thrombus formation on the artificial membrane in addition to anticoagulant action within blood vessels.
