Objective: To investigate the biocompatibility of dialyzer reuse.
Methods: Twenty-two hemodialysis patients were randomized into cuprophan (CU, 7), polymethylmethacrylate (PMMA, 7) and polysulphone (PS, 8) membrane groups to observe IL-1 beta, TNF-alpha, IL-6 gene expression and their plasma levels by using themselves as control with enzyme-linked immunosorbent assay (ELISA), reverse transcription-polymerase chain reaction (RT-PCR) and in situ hybridization.
Results: Plasma levels of interlukin-1 beta (IL-1 beta), tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6) were 14.07 +/- 3.32 pg/ml, 67.41 +/- 19.79 pg/ml, 83.67 +/- 40.34 pg/ml; 12.80 +/- 3.01 pg/ml, 49.65 +/- 9.75 pg/ml, 33.36 +/- 12.14 pg/ml and 14.41 +/- 3.16 pg/ml, 80.56 +/- 23.22 pg/ml, 48.14 +/- 16.01 pg/ml, respectively, after patients dialyzed with CU, PMMA and PS membranes. Plasma cytokine levels decreased after reuse compared with those before reuse in each group. But no significant difference was found between them (P > 0.05); the levels of IL-1 beta, TNF-alpha, IL-6 gene expression after reuse were 5.61 +/- 0.33, 2.11 +/- 0.12, 5.04 +/- 0.19%; 2.43 +/- 0.19, 1.29 +/- 0.11, 3.48 +/- 0.20% and 2.48 +/- 0.20, 1.24 +/- 0.11, 3.22 +/- 0.20% respectively by in situ hybridization, and 0.92 +/- 0.07, 0.63 +/- 0.05, 0.53 +/- 0.05; 0.61 +/- 0.06, 0.47 +/- 0.04, 0.37 +/- 0.03 and 0.59 +/- 0.05, 0.44 +/- 0.04, 0.38 +/- 0.03 by RT-PCR, respectively. After reuse there was significant decrease as compared with that before reuse (P < 0.001, P < 0.005 and P < 0.05, respectively).
Conclusions: This suggested reprocessing dialyzer with formaldehyde reduced cytokine release and gene expression in peripheral blood mononuclear cells and enhanced dialyzer biocompatibility. It would be beneficial to reduce the dialysis cost and may reduce the complication related to a long term hemodialysis.