Membrane Bioincompatibility and Ultrafiltration Effects on Pulse Wave Analysis during Haemodialysis

Abstract

Membrane bioincompatibility was demonstrated by successive white blood cell counts and C3a generation. Pulse wave analysis was obtained by applanation tonometry (SphygmoCor) in a sequential way: basal, after 30 minutes with nul ultrafiltration, and after a complete dialysis with ultrafiltration. At 15 minutes of haemodialysis, significant decrease in leukocyte count occurred: versus (), while C3a levels sharply increased from to  ng/mL (). No changes were observed in augmentation index without ultrafiltration: versus . Only aortic systolic blood pressure was lower at 15 minutes: versus  mmHg (), in agreement with a reduction in brachial systolic blood pressure: versus  mmHg (), without changes in aortic or brachial diastolic blood pressure. Important changes in pulse wave analysis were observed after a complete haemodialysis session: augmentation index versus , aortic systolic blood pressure versus mmHg (), without changes in aortic diastolic blood pressure. In summary, haemodialysis with cellulose diacetate acutely induced a transient state of immunoactivation due to bioincompatibility, this phenomenon was nondetectable by pulse wave analysis. Complete haemodialysis session led to important changes in pulse wave analysis.