gms | German Medical Science

Biocompatibility of hemodialysis membranes has substantial impact on mortality of patients with end stage renal failure. In the present study the effects of hemodialysis on intracellular amount of diadenosine polyphosphate (Ap5A), a hydrophilic, anionic substance with low molecular weight, was investigated. Intracellular Ap5A concentrations were measured before and after hemodialysis using acrylonitrile-sodium-methalyl-sulfonate membrane (AN69) and polysulfone membranes (n=23). Ap5A was isolated from platelets using affinity chromatography and reversed phase chromatography methods. Ap5A concentrations were quantified by UV-absorption at 254 nm. Ap5A concentrations were significantly higher in platelets from patients with end-stage renal failure compared to 21 healthy control subjects (136 ± 50 fg/platelet vs 9 ± 6 fg/platelet, mean ± SEM, p<0.01).

Before hemodialysis intracellular Ap5A concentrations in platelets from 10 patients with end-stage renal failure using an AN69 membrane were not significantly different from those in platelets from 23 patients using polysulfone membrane (93 ± 39 fg/platelet vs 155 ± 70 fg/platelet).

However, after a hemodialysis session intracellular Ap5A concentrations in platelets from patients with end-stage renal failure using an AN69 membrane were significantly lower compared to those in platelets before hemodialysis (51 ± 18 fg/platelet vs 93 ± 39 fg/platelet, p<0.05) as well as compared to those in platelets from patients using polysulfone membrane (51 ± 18 fg/platelet vs 250 ± 59 fg/platelet, p<0.05).

It is concluded that the hemofiltration by using an acrylonitrile-sodium-methalyl-sulfonate membrane (AN69) has a direct effect on the intracellular amount of diadenosine pentaphosphate and that changes of intracellular hydrophilic substances are dependent on the hemodialysis membrane used.