#3798 A MULTICENTER CLINICAL STUDY OF CELLULOSE TRIACETATE MEMBRANES AND POLYSULFONE MEMBRANE DIALYZERS IN MAINTENANCE HEMODIALYSIS PATIENTS
Authors: Chen Chen , Zhou Guang-Yu 
Published: June 2023

Abstract

Background and Aims
With the continuous improvement of dialysis membrane materials, polysulfone (PS) has replaced traditional cellulose membranes with excellent biocompatibility and dominates the market applications. In our clinical work, we found that the allergic reaction disappeared after the application of cellulose triacetate (CTA) in patients who were allergic to PS. In this study, we compared the differences in biocompatibility and solute clearance of CTA and PS dialyzers during long-term dialysis treatment.

Method
In this study, a multicenter clinical study was conducted, and patients attending Fuxin Mining Bureau Hospital, Northeast International Hospital and Shenyang Medical College Affiliated Central Hospital receiving maintenance hemodialysis from April 2019 to April 2020 were selected as the study population. The patients were divided into a polysulfone membrane group (n = 10) and a cellulose triacetate membrane group (n = 13) based on whether they tolerated the polysulfone membrane dialyzer, and all patients in the CTA group had an allergic reaction to the polysulfone membrane dialyzer. The effects of the two membranes on White Blood Cell (WBC), platelet (PLT), Hemoglobin(Hb), Complement3(C3), Complement4(C4), Tumor Necrosis Factor-α (TNF-α), Interleukin-1 (IL-1), interleukin-6 (IL-6), hypersensitive C-reactive protein (hs CRP), IgE, serum phosphorus (P), creatinine (CR), blood urea nitrogen (BUN), parathyroid hormone (PTH) were compared before and after the single dialysis session and after 12 months of dialysis,and Urea removal rate (URR) and spKt /V were calculated.

Results
There were no statistically significant differences between the two groups in the comparison of basic information such as age, gender, dialysis age and primary disease. Before the application of CTA and PS dialyzer treatment, there was no statistically significant comparison between groups for all observed indicators. After application of CTA and PS single dialysis: (i) The difference between the 2 groups of β2-MG (Z = -2.039, P = 0.041) and TNF-α (Z = -2.491, 0.013) was statistically different. (ii) There were no statistically significant differences between two groups in the comparison of hematological system, such as WBC, PLT, HB; complement, such as C3, C4; inflammatory factors, such as: IL-1, IL-6, hs CRP, IgE; uremic toxins, such as: P, CR, BUN, PTH (P&gt;0.05). After the 12th month of regular hemodialysis treatment with PS and CTA: (i) The differences between the 2 groups for P (Z = -2.096, P = 0.036), BUN (Z = -2.038, P = 0.042), and spKt/V (t = -2.147, P = 0.049) were statistically significant. (ii) The difference between the 2 groups after 12 months of dialysis P (t = 0.114, P = 0.041) and before dialysis was statistically different between groups, and the other indexes mentioned above were not statistically different.

Conclusion
After a single dialysis session, TNF-αin the PS group was elevated and the biocompatibility of CTA was better than PS. The CTA group had better clearance of β2-MG than PS, and spKt/V reached the standard. After long-term dialysis, the effect of CTA on inflammation and complement system was not different compared with PS, and there was no difference in biocompatibility between the two membranes. spKt/V in the CTA group reached the standard, and the clearance of BUN and P was better than that of PS.