A new polymethylmetacrylate membrane improves the membrane adhesion of blood components and clinical efficacy

• Main Authors: Ikuto Masakane, Shiho Esashi, Asami Yoshida, Tetsuro Chida, Hiroaki Fujieda, Yoshiyuki Ueno, Hiroyuki Sugaya
• Format: Article
• Language: English
• Published: BMC 2017-07-01
• Series: Renal Replacement Therapy
• Subjects: Dialysis; PMMA membrane; Protein adsorption; Hemocompatibility
• Online Access: http://link.springer.com/article/10.1186/s41100-017-0112-0

Abstract Background Hemodialysis with polymethylmetacrylate (PMMA) membrane dialyzers allows unique protein adsorption. New PMMA dialyzers should demonstrate equivalent protein adsorption, but improved hemocompatibility. Methods Platelet adhesion and activation and protein adsorption were determined for the new PMMA membrane dialyzer Filtryzer® NF (NF) and conventional Filtryzer® BG (BG) in vitro. In clinical study, six subjects were treated with NF and BG for 3 months each in a crossover design. Three months after the use of each dialyzer, solute removal, hemocompatibility, peripheral circulation by skin perfusion pressure (SPP), and other dialysis-related side effects were also compared. Results Protein adsorption pattern was similar on NF and BG, but platelet adhesion and activation were much lower on NF in vitro. Clinically, NF and BG removed equivalent amounts of small molecule solutes and low-molecular-weight proteins. The platelet count and peripheral circulation were stable during dialysis with NF, whereas both were decreased during dialysis with BG. The percent changes in SPP were significantly smaller with NF compared with BG. Data on the dialysis-related side effects were no significant differences in any individual items or in the mean total score for the two groups, but the mean score of the seven items tended to be lower with NF. Protein adsorption by the membranes is considered one factor associated with clinically improvements. But activated platelets induce the aggregation of platelets, leukocytes, and erythrocytes, which can interfere with peripheral circulation during dialysis. Decreased peripheral circulation causes dialysis-related side effects. Therefore reduced platelet activation during dialysis by NF may be significant in improving the prognosis of patients, as well as reducing the frequency of side effects. Conclusions The new PMMA membrane dialyzer NF shows substantially improved hemocompatibility. We expect this product will improve the condition of chronic dialysis patients. Trial registration UMIN000024955