Abstract: TH-PO251
Intradialytic Microvascular Tissue Perfusion Is Affected by Dialyzer Membrane Characteristics
Session Information
- Hemodialysis, Hemodiafiltration, and Frequent Dialysis
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Janssen, Barry, Lawson Health Research Institute, London, Ontario, Canada
- Zhang, Yanmin, Western University, London, Ontario, Canada
- Hur, Lisa, Lawson Health Research Institute, London, Ontario, Canada
- Akbari, Alireza, Lawson Health Research Institute, London, Ontario, Canada
- McIntyre, Christopher W., Lawson Health Research Institute, London, Ontario, Canada
Background
During hemodialysis (HD), microvascular perfusion in tissues and organs is often compromised. The role of dialyzer clearance characteristics and general biocompatibility in this process is unknown. This study compared the effects of HD using either conventional high flux polysulfone (PSF) or newer mid-cut-off (MCO) dialyzers (characterized by an extended clearance spectrum into the middle molecule range) on microvascular perfusion in an established rat model of HD. We hypothesize that using different dialyzer membranes will result in different microvascular responses, affecting the quality of tissue blood flow.
Methods
HD using in-house-designed mini-dialyzers was performed on male Wistar Kyoto rats, and microvascular perfusion in skeletal muscle was observed using intravital video microscopy. A carotid catheter was used for hemodynamic monitoring, while indwelling catheters in the left femoral artery and left femoral vein were connected to the mini-dialyzer. Blood samples were taken for biochemical analysis, a C5b-9 ELISA assay and hematocrit determination to ensure the procedure was euvolemic.
Results
HD using PSF dialyzers significantly reduced microvascular muscle perfusion, unlike the MCO dialyzers (Fig 1). Blood pressure reduction was similar between the two groups, with a better conservation of the cardiac response in the MCO group. There were no differences in small solute clearance or circulating electrolyte levels. Analysis of [C5b-9] plasma levels shows significantly higher levels after a two-hour HD procedure with PSF dialyzers.
Conclusion
Our analysis indicates that the separate effects of the different dialyzers on microvascular perfusion may be related to differences in complement activation. The exact mechanisms underlying these differences warrant further study. This small animal model allows us to preclinically evaluate membrane materials and dialyzer designs, facilitating the design of subsequent human studies.
Funding
- Other NIH Support – Baxter International