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Biocompatibility of dialysis membrane.

During the last years, the progress in membrane development has contributed to the improvement of hemodialysis (HD) treatment. The performance of a dialyzer membrane is determined by its structure, overall mass transfer properties, and biocompatibility. Membrane biocompatibility, however, is not exclusively influenced by the membrane structure but also by the medication taken during dialysis and patient's underlying disease. The contact of dialyzer membranes with blood may stimulate an alternative pathway of the complement system, activation of the kinin system, activation of the coagulation system, generation of the fibrinolytic activity, as well as activation of the plasma immune system. Although the cell biological and biochemical consequences of bioincompatibility during HD have been extensively studied, the clinical significance of these changes still remains controversial. Recent data suggest that in acute and chronic HD patients, the biocompatibility of the dialysis membrane is an important predictor of morbidity and mortality.