Cinical Investigation

Kidney International (1986) 30, 74–80; doi:10.1038/ki.1986.153

Compartmental distribution of complement activation products in artificial kidneys

Alfred K Cheung, Dennis E Chenoweth, Dawn Otsuka and Lee W Henderson

Department of Medicine, University of Utah School of Medicine and the Veterans Administration Medical Center, Salt Lake City, Utah; Department of Pathology and Medicine, University of California at San Diego and Veterans Administration Medical Center, San Diego, California, U.S.A.

Correspondence: Alfred K Cheung, Renal Section (11H), Veterans Administration Medical Center, 500 Foothill Drive; Salt Lake City, Utah 84148, U.S.A.

Received 8 August 1985; Revised 11 December 1985.

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Abstract

Compartmental distribution of complement activation products in artificial kidneys. The compartmental distribution of the human anaphylatoxins C3a and C5a has been defined during simulated hemodialysis performed with various types of hemodialyzers. New cuprophan hollow fiber dialyzers were found to activate human complement very readily in vitro, while re-used cuprophan dialyzers displayed only modest complement activating potential. The C3a and C5a antigens, formed as a result of complement activation in these dialyzers, accumulated predominantly in the blood path and were not adsorbed extensively on the membrane surface or transported into the dialysate compartment. Cellulose acetate membranes also produced complement activation in vitro, but to a lesser degree than new cuprophan hollow fibers. However, these membranes exhibited a significant capacity to bind the anaphylatoxins to their surface. Polyacrylonitrile membranes appeared to be unique in that they not only failed to activate complement significantly, but they rapidly adsorbed large quantities of C3a and C5a. These findings demonstrate that hemodialysis membranes may differ with regard to their complement activating potential as well as their ability to remove circulating anaphylatoxins from the blood path. Clinical measurements of anaphylatoxin production during hemodialysis reflect these dynamic events.

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