Leukocyte Counts and Complement Activation During Arteriovenous and Pump-Driven Hemofiltration

Significant leukopenia accompanied by complement activation and impairment of pulmonary function [1, 16] after starting a dialysis treatment were first observed by Kaplow and Goffinet in 1968 [13]. These changes are most striking when cuprophane membranes are used for dialysis [12]. Craddock et al. have studied these side effects of hemodialysis thoroughly and postulate the following pathogenesis: The complement system is activated during contact of the plasma with the dialyzer membrane [3, 4]. C5a fragment of the complement component C5 induces aggregation of granulocytes in the patient’s venous blood [5, 10, 17]. These aggregates are trapped in the pulmonary microvessels resulting in a transient, profound leukopenia of the peripheral blood [19].