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Influence of citrate concentration on the activation of blood cells in an in vitro dialysis setup
BACKGROUND: Regional citrate anticoagulation has been associated with enhanced biocompatibility in hemodialysis, but the optimal dose of citrate remains to be established. Here, we compared parameters related to cellular activation during in vitro dialysis, using two doses of citrate. METHODS: Human...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5999235/ https://www.ncbi.nlm.nih.gov/pubmed/29898003 http://dx.doi.org/10.1371/journal.pone.0199204 |
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author | Gubensek, Jakob Strobl, Karin Harm, Stephan Weiss, Rene Eichhorn, Tanja Buturovic-Ponikvar, Jadranka Weber, Viktoria Hartmann, Jens |
author_facet | Gubensek, Jakob Strobl, Karin Harm, Stephan Weiss, Rene Eichhorn, Tanja Buturovic-Ponikvar, Jadranka Weber, Viktoria Hartmann, Jens |
author_sort | Gubensek, Jakob |
collection | PubMed |
description | BACKGROUND: Regional citrate anticoagulation has been associated with enhanced biocompatibility in hemodialysis, but the optimal dose of citrate remains to be established. Here, we compared parameters related to cellular activation during in vitro dialysis, using two doses of citrate. METHODS: Human whole blood, anticoagulated with either 3 mM or 4 mM of citrate, was recirculated in an in vitro miniaturized dialysis setup. Complement (C3a-desArg), soluble platelet factor 4 (PF4), thromboxane B2 (TXB2), myeloperoxidase (MPO), as well as platelet- and red blood cell-derived extracellular vesicles (EV) were quantified during recirculation. Dialyzer fibers were examined by scanning electron microscopy after recirculation to assess the activation of clotting and the deposition of blood cells. RESULTS: Increases in markers of platelet and leukocyte activation, PF4, TXB2, and MPO were comparable between both citrate groups. Complement activation tended to be lower at higher citrate concentration, but the difference between the two citrate groups did not reach significance. A strong increase in EVs, particularly platelet-derived EVs, was observed during in vitro dialysis for both citrate groups, which was significantly less pronounced in the high citrate group at the end of the experiment. Assessment of dialyzer clotting scores after analysis of individual fibers by scanning electron microscopy revealed significantly lower scores in the high citrate group. CONCLUSIONS: Our data indicate that an increase in the citrate concentration from 3 mM to 4 mM further dampens cellular activation, thereby improving biocompatibility. A concentration of 4 mM citrate might therefore be optimal for use in clinical practice. |
format | Online Article Text |
id | pubmed-5999235 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-59992352018-06-21 Influence of citrate concentration on the activation of blood cells in an in vitro dialysis setup Gubensek, Jakob Strobl, Karin Harm, Stephan Weiss, Rene Eichhorn, Tanja Buturovic-Ponikvar, Jadranka Weber, Viktoria Hartmann, Jens PLoS One Research Article BACKGROUND: Regional citrate anticoagulation has been associated with enhanced biocompatibility in hemodialysis, but the optimal dose of citrate remains to be established. Here, we compared parameters related to cellular activation during in vitro dialysis, using two doses of citrate. METHODS: Human whole blood, anticoagulated with either 3 mM or 4 mM of citrate, was recirculated in an in vitro miniaturized dialysis setup. Complement (C3a-desArg), soluble platelet factor 4 (PF4), thromboxane B2 (TXB2), myeloperoxidase (MPO), as well as platelet- and red blood cell-derived extracellular vesicles (EV) were quantified during recirculation. Dialyzer fibers were examined by scanning electron microscopy after recirculation to assess the activation of clotting and the deposition of blood cells. RESULTS: Increases in markers of platelet and leukocyte activation, PF4, TXB2, and MPO were comparable between both citrate groups. Complement activation tended to be lower at higher citrate concentration, but the difference between the two citrate groups did not reach significance. A strong increase in EVs, particularly platelet-derived EVs, was observed during in vitro dialysis for both citrate groups, which was significantly less pronounced in the high citrate group at the end of the experiment. Assessment of dialyzer clotting scores after analysis of individual fibers by scanning electron microscopy revealed significantly lower scores in the high citrate group. CONCLUSIONS: Our data indicate that an increase in the citrate concentration from 3 mM to 4 mM further dampens cellular activation, thereby improving biocompatibility. A concentration of 4 mM citrate might therefore be optimal for use in clinical practice. Public Library of Science 2018-06-13 /pmc/articles/PMC5999235/ /pubmed/29898003 http://dx.doi.org/10.1371/journal.pone.0199204 Text en © 2018 Gubensek et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Gubensek, Jakob Strobl, Karin Harm, Stephan Weiss, Rene Eichhorn, Tanja Buturovic-Ponikvar, Jadranka Weber, Viktoria Hartmann, Jens Influence of citrate concentration on the activation of blood cells in an in vitro dialysis setup |
title | Influence of citrate concentration on the activation of blood cells in an in vitro dialysis setup |
title_full | Influence of citrate concentration on the activation of blood cells in an in vitro dialysis setup |
title_fullStr | Influence of citrate concentration on the activation of blood cells in an in vitro dialysis setup |
title_full_unstemmed | Influence of citrate concentration on the activation of blood cells in an in vitro dialysis setup |
title_short | Influence of citrate concentration on the activation of blood cells in an in vitro dialysis setup |
title_sort | influence of citrate concentration on the activation of blood cells in an in vitro dialysis setup |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5999235/ https://www.ncbi.nlm.nih.gov/pubmed/29898003 http://dx.doi.org/10.1371/journal.pone.0199204 |
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