The clinical performance during first use of a new membrane manufactured from a blend of polyarylethersulfone and
polyvinylpyrrolidone (
Arylane; Hospal Renal Care, Lyon, France), in which the microstructure of the membrane has been tailored by the manufacturing process and
polymer blend, has been compared with Fresenius
Polysulfone (Fresenius Medical Care, Bad Homburg, Germany) in a prospective, randomized, crossover study. Small-molecular clearances were similar. A reduction in plasma beta(2)-microglobulin levels was present using both membranes, with a significantly greater removal by
Arylane such that the mean postdialysis plasma level difference between the membranes at the end of dialysis was 8. 7 mg/L (95% confidence interval, 3.9 to 13.5; P = 0.004). Recovery of beta(2)-microglobulin from the dialysis fluid was similar: 170 +/- 70 mg for
Arylane and 110 +/- 60 mg for Fresenius
Polysulfone (P = 0.04). Both membranes were impermeable to
albumin but allowed the passage of low-molecular-weight
proteins, with 10,046 +/- 3,239 mg for
Arylane and 7,285 +/- 2,353 mg for Fresenius
Polysulfone recovered from the dialysis fluid (P = 0.07).
Neutropenia and platelet adhesion to the membrane were minimal, and time-averaged
complement levels during dialysis for C3a and
C5b-9 were 207 +/- 92 and 62 +/- 24 ng/mL for
Arylane and 223 +/- 68 and 45 +/- 24 ng/mL for Fresenius
Polysulfone, respectively, and were membrane independent. This study indicates that the membrane using polyarylethersulfone in conjunction with PVP has complement-activation potential and
neutropenia similar to Fresenius
Polysulfone but has an enhanced capacity to remove beta(2)-microglobulin. This enhanced removal arises from transmembrane transport augmented by adsorption within the membrane matrix.