Two cases of severe thrombocytopenia developed by maintenance hemodialysis therapy with FPX polysulfone membranes

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  • ポリスルホン膜ＦＰＸによる血小板数減少が示唆された維持血液透析患者―２症例の報告―
  • 症例報告 ポリスルホン膜FPXによる血小板数減少が示唆された維持血液透析患者--2症例の報告
  • ショウレイ ホウコク ポリスルホン マク FPX ニ ヨル ケッショウバンスウ ゲンショウ ガ シサ サレタ イジ ケツエキ トウセキ カンジャ 2 ショウレイ ノ ホウコク
  • ―2症例の報告―

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Abstract

In hemodialysis therapy, blood-material contact during extracorporeal circulation can cause various biological reactions. Intradialytic activation of leukocytes is one of the major causes of hemodialysis-associated complications. Platelets and coagulation system are also activated by blood-membrane contact. The activation of platelets and coagulation system results in platelet adhesion on the dialyzer membrane, a release of growth and activating factors, platelet aggregation and consequently clotting in the extracorporeal circuit. Such reactions can play an important role not only in dialysis-related side-effects, but also various complications in patients on hemodialysis. We report two cases of severe thrombocytopenia developed by maintenance hemodialysis. Significant decreases in the platelet count were observed and considered a dialysis-related complication. The platelet counts decreased after we changed their dialyzers to FPX®(Fresenius Medical Care Japan, Tokyo, Japan), a novel high-flux polysulfone dialyzer membrane. The platelet counts were improved to the normal range after we changed these dialyzers to different polysulfone membranes. The medications were not changed before or after the onset of thrombocytopenia. Heparin induced thrombocytopenia (HIT) and disseminated intravascular coagulation (DIC) were ruled out. Activation coagulating time was also evaluated. Although FPX® is one of the most efficient and clinically well-tolerated membrane polymers used for hemodialysis treatment, our findings suggest that FPX® may cause severe thrombocytopenia in some patients.

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