Hyperthrombotic State in Patients on Different Hemodialysis Membranes

Background. The patients on hemodialysis (HD) suffer from permanent hyperthrombotic condition. The aim of the study was to estimate hyperthrombotic state in HD patients regarding different HD membranes. Methods. The biological activity of von Willebrand factor (vWf) was determined in 104 patients (64 males, 40 females, at age of 42±12 years) using the platelet agglutination in presence of ristocetin (Dade Behring, Germany) on different HD membranes: Cuprophan (CU) (n=30), Polymethylmethacrylate (PMMA) (n=30), Hemophan (HE) (n=24) and Polysulfone (PS) (n=20). Fibrinolysis activators (routine method with standardized fibrin plates) and prothrombine time (PT) (Dade Behring, Germany) were examined in 43 patients (28 males and 15 females at age of 40± 9 years) who were on: HE (n=24) and PS (n=19). In 40 patients (25 males and 15 females at age of 41±11 years) who were on HE (n=17), PS (n=11) and CU (n=12), nitric oxide (NO) level was examined (OXIS, USA). Patients’ groups were compared to 30 healthy control subjects who were age and sex matched. Results. The biological activity of vWf showed increased values even before the HD session in all examined groups with further increase after HD. The most significant increase of vWf activity during HD was observed in patients on PMMA membrane, 128±32% vs. 234±28%, (p<0.001) before and after HD, respectively. There was no significant increase of vWf activity in patients on PS membrane, 133±31% before, vs. 140±30% after HD. PT was shortened after HD in patients on the two examined membranes, for HE membrane from 10±1.9 to 9±0.6 seconds and for PS from 10±0.7 to 8.9± 0.6 seconds (p<0.05). Compared to controls, PT was shortened in HD patients before the HD. There was no significant difference in fibrinolytic response between patient’ groups and controls, being at similar levels before and after HD. No statistical significance for NO was found before and after HD session in none of the patients groups on different HD membranes, but the patients had much higher value than the controls (p<0.001). Conclusions. In conclusion, there was hemostasis activation in HD patients and the best membrane profile from all examined membranes was shown to be the PS type since there were only minimal changes in the examined parameters after HD session.