Biomedical Engineering Advances (Dec 2022)
Influence of hydration shell of hemodialysis clinical membranes on surrogate biomarkers activation in uremic serum of dialysis patients
Abstract
End-stage renal disease (ESRD) patients depend on hemodialysis (HD) as a life-sustaining treatment. Cytokines are essential mediators of immune response and inflammatory reactions. Our goal is to study the impact of known properties of commercially available clinical HD membranes on the activation of inflammatory biomarkers. Two common clinical HD membranes of cellulose triacetate and polyarylethersulfone were thoroughly characterized. Surrogate biomarkers were studied at different time points after in vitro exposure of normal and uremic serum to hydrated and unhydrated membranes. In vitro adsorption of fibrinogen (FB) by hydrated and unhydrated CTA and PAES membranes was also compared at similar clinical practices. The inflammatory biomarkers released in HD patients after 30 min of dialysis were also compared to those induced in uremic samples incubated with HD membranes for 30 min to determine the influence of shear rate and membrane roughness. Samples from male and female patients were collected to assess the influence of patient sex on inflammatory and thrombotic responses. The results obtained indicate CTA membranes have a smoother surface and are more hemocompatible, while PAES membranes had a rougher surface and greater hydrophilicity, which resulted in a significant increase in red blood cell (RBC) rupture and promoted protein adsorption and higher cytokines levels. Unhydrated PAES membranes adsorbed more protein than all other membranes tested, and unhydrated CTA and PASE membranes induced more cytokines compared to hydrated counterparts. Overall, hydrating the membrane materials was determined to alter their adsorptive behavior.
