Reactions to the hemodialysis membrane
- Alessandro Bellucci, MD
Alessandro Bellucci, MD
- Associate Professor of Medicine
- Hofstra-North Shore LIJ School of Medicine
Dialyzer reactions refer to all of the abnormal sequelae resulting from the interaction between blood constituents and the hemodialysis membrane. There are two types of reactions: type A and type B . In the past, these reactions were grouped under the term "first-use syndrome" because they primarily occurred with new dialyzers. Before discussing the characteristics of these disorders, it is helpful to review the different types of dialyzers since they can affect the frequency and type of reaction seen. The longer-term clinical consequences of exposure to dialysis membranes are discussed separately. (See "Clinical consequences of hemodialysis membrane biocompatibility".)
TYPES OF HEMODIALYSIS MEMBRANES
There are four types of membranes currently used to manufacture dialyzers :
●Cellulose, also called cuprophan (or cuprophane), is a polysaccharide-based membrane obtained from pressed cotton. It is composed of chains of glucosan rings with abundant free hydroxyl groups.
●Substituted cellulose membranes are obtained by chemical bonding of a material to the free hydroxyl groups at the surface of the cellulose polymer. The most common type is cellulose acetate, in which acetate replaces 80 percent of the hydroxyl groups.
●Cellulosynthetic membranes are modified by the addition of a synthetic material (such as diethylaminoethyl in the production of Hemophane) to liquefied cellulose during its formation.
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