Introduction:
The hydration and water stability of hemodialysis membranes significantly impact their biocompatibility and the regulation of inflammatory biomarkers. Among these biomarkers, von Willebrand Factor (vWF) plays a crucial role in platelet adhesion and blood clot formation, while the membrane attack complex (C5b-9) is involved in cell lysis and immune response. Dysregulation of these biomarkers can lead to thrombotic complications and excessive tissue damage during hemodialysis. This study investigates the relationship between non-freezable water content, freezing point, and the release of vWF and C5b-9 across various modified polyethersulfone (PES) membranes.
Methods:
Various PES-based hemodialysis membranes, including unmodified PES, hydrophobized PES, and heparin-based PES membrane with pseudo-ZW (pZW) modification, were evaluated. Differential Scanning Calorimetry (DSC) was used to measure the non-freezable water content and freezing points to assess membrane hydration stability. The release of vWF and C5b-9 from these membranes during dialysis was quantified using human magnetic Luminex assays in a cohort of five hemodialysis patients and three healthy controls. All samples were tested in triplicate, and statistical analysis was performed using the Shapiro–Wilk normality test.
Results:
The study demonstrated that membrane hydration and water stability strongly correlate with the release of inflammatory biomarkers during hemodialysis. Membranes with high non-freezable water content, such as Heparin-pseudo-ZW (32.22%), exhibited significantly reduced vWF (by 45.67%) and C5b-9 (by 13.66%) release, indicating enhanced biocompatibility. In contrast, the hydrophobized PES membrane, with much lower non-freezable water content (1.09%), showed a 25.22% reduction in vWF but a substantial 176.99% increase in C5b-9, suggesting an unfavorable increase in complement activation, thereby highlighting the risks associated with insufficient membrane hydration stability.
Conclusions:
There is a clear correlation between the hydration properties of hemodialysis membranes and their biocompatibility. Membranes with higher hydration levels, indicated by greater non-freezable water content and lower freezing points, show a significant reduction in the release of inflammatory biomarkers, particularly vWF and C5b-9. Conversely, membranes with lower hydration tend to increase C5b-9 levels, suggesting that optimizing membrane hydration is crucial for minimizing both clot formation and inflammatory damage during hemodialysis. These findings underscore the importance of balanced membrane design to improve patient outcomes. Future studies should explore further modifications to enhance membrane hydration stability, potentially leading to even greater improvements in biocompatibility and patient outcomes.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.