H WESTPHALEN 1, A ABDELRASOUL A1, A SHOKER 1
1University Of Saskatchewan, Saskatoon, Canada
Aim: This study aimed to analyze the influence of blood flow rate (BFR), treatment time (t) and biological sex on the activation of complement system experienced by haemodialysis (HD) patients and correlate it to adsorption of fibrinogen (FB) to obtain a mechanistic understanding of the biochemical cascade.
Background: Protein adsorption play a key role in triggering the activation of complement and coagulation cascades. In addition to the membrane biocompatibility, the clinical operating conditions have been observed to impact dialysis adequacy and patient outcomes. However, there is a wide variability on the prescription of BFR and the impact on patients’ health point to the need of optimizing the clinical practices.
Methods:Twelve HD patients prescribed a polyarylethersulfone polyvinylpyrrolidone (PAES-PVP) dialyzer were recruited from Saint Paul’s Hospital in Saskatoon (Canada). Blood samples were collected at times 0, 30, 90 and 240 minutes. The levels of complement component 5a (C5a), membrane attack complex (C5b-9), interleukin 6 (IL-6) and von Willebrand factor (vWF) were assess using Luminex assays. In-vitro protein adsorption was assessed utilizing an aqueous protein solution at 2 mg/mL. The collected data was correlated to the levels of biomarkers from patients at the corresponding flow rate.
Results: In-vitro adsorption showed that lower flow rate promotes more severe adsorption of FB. In turn, lower BFR triggered more complement activation as well as coagulation, clotting, and inflammatory responses compared to higher BFR. This way a correlation between FB adsorption and complement activation was demonstrated. Male patients experienced more severe inflammatory responses than female patients.
Conclusion: The results of this study demonstrated a mechanistic understanding of the impact of BFR and protein adsorption on complement activation during HD.
Heloisa Westphalen is a PhD student at the University of Saskatchewan, Canada. Her GPA is 92%. For her academic excellence, she was awarded the Russell (Russ) William Haid Memorial Awards and the Devolved Scholarship with the first top rank. Her Ph.D. project at Membrane Science and Nanotechnology under the supervision of Dr. Amira Abdelrasoul represents a critical innovation in the hemodialysis membrane research fields and a vital response to pressing issues that clinicians want solved. The outcomes of her research will help improve clinical practices in hemodialysis aiming to improve patients’ quality of life in Canada.