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      Is Platelet-Activating Factor Produced during Hemodialysis with AN-69 Polyacrylonitrile Membrane?

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          Abstract

          Background: Platelet-activating factor (PAF) production during hemodialysis (HD) with cuprophane (CU) membrane has previously been demonstrated, while the results regarding PAF production during HD with AN-69 polyacrylonitrile membrane are dubious. In this study an attempt is made to show that PAF is produced during HD using AN-69 membrane while comparing this production with the corresponding one from HD with CU. Since previous studies have indicated that PAF, like the complement system, could also be implicated in HD-related leukopenia and thrombocytopenia (especially when CU membrane is used), the circulating leukocyte and platelet counts as well as the C3a-desArg and SC5b-9 (soluble, nonlytic form of the terminal complement complex) levels were measured. Methods: Ten hemodialyzed patients were subjected to HD with CU and AN-69 membranes for 2 consecutive weeks (first week with CU and second with AN-69). During the third HD session of each week and at different times (0, 2, 5, 15, 30, 60, 180 and 240 min), the PAF levels in the blood as well as the leukocyte and platelet counts were measured, while the circulating levels of the C3a-desArg and SC5b-9 were measured at 0, 5, 15, 60 and 240 min. PAF was detected by ethanol extraction, followed by purification by column chromatography and high-pressure liquid chromatography and finally quantified by bioassay. The C3a-desArg and SC5b-9 fractions of the complement were measured by immunoassay while an autoanalyzer gave the leukocyte and platelet counts. Results: Circulating PAF levels were detected at all time intervals during HD with AN-69 (PAF<sub>AN-69</sub>) and CU (PAF<sub>CU</sub>) membranes. At all time intervals PAF<sub>AN-69</sub> < PAF<sub>CU</sub>, however, statistically significant differences (s) between the two membranes existed only at 15, 30, 60, 180 and 240 min. The highest PAF<sub>AN-69</sub> and PAF<sub>CU</sub> occurred at 5 and 15 min into dialysis, respectively. The same observations were made for circulating C3a-desArg levels (s existed additionally at 5 min as well). The reduction of the circulating leukocytes had almost a mirror image with the C3a-desArg as well as PAF levels while the maximal reduction of platelets was observed after 2 min into dialysis with both membranes (i.e., simultaneously with the first increase in PAF secretion). Conclusions: PAF is indeed produced during HD with AN-69 membrane, as it is during HD with CU. At all time intervals during the HD procedure, PAF<sub>AN-69</sub> < PAF<sub>CU</sub>. PAF seems to contribute to HD-related leukopenia and thrombocytopenia with both membranes.

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          The role of platelet-activating factor in inflammation.

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            Author and article information

            Journal
            NEF
            Nephron
            10.1159/issn.1660-8151
            Nephron
            S. Karger AG
            1660-8151
            2235-3186
            2002
            May 2002
            02 May 2002
            : 91
            : 1
            : 86-93
            Affiliations
            aDepartment of Nephrology, General Hospital of Nikaias-Pereaus; bDepartment of Nephrology, General Hospital of Athens; cFaculty of Chemistry, National and Capodistrian University of Athens; dDepartment of Immunology and Tissue Typing Centre, General Hospital of Athens; eDepartment of Science of Dietetics and Nutrition, Harokopio University, Athens, Greece
            Article
            57609 Nephron 2002;91:86–93
            10.1159/000057609
            12021524
            © 2002 S. Karger AG, Basel

            Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

            Page count
            Figures: 5, References: 62, Pages: 8
            Product
            Self URI (application/pdf): https://www.karger.com/Article/Pdf/57609
            Categories
            Original Paper

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