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Table of Contents
Vol. 13, No. 6, 1993
Issue release date: 1993
Section title: Clinical Study
Am J Nephrol 1993;13:473–477
(DOI:10.1159/000168666)

Role of Bradykinin in Anaphylactoid Reactions during Hemodialysis with AN69 Dialyzers

Schaefer R.M.a · Fink E.b · Schaefer L.a · Barkhausen R.a · Kulzer P.a · Heidland A.a
aDepartment of Nephrology, University of Würzburg; bDepartment of Clinical Biochemistry, University of Munich, FRG

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Article / Publication Details

First-Page Preview
Abstract of Clinical Study

Received: August 03, 1993
Accepted: September 23, 1993
Published online: October 28, 2008
Issue release date: 1993

Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 0

ISSN: 0250-8095 (Print)
eISSN: 1421-9670 (Online)

For additional information: http://www.karger.com/AJN

Abstract

In vitro experiments have related anaphylactoid reactions in patients treated with angiotensin-converting enzyme (ACE) inhibitors during dialysis with AN69 membranes to excessive bradykinin generation using this negatively charged dialysis membrane. In the present clinical trial plasma bradykinin levels were followed during the early phase of dialysis in 10 patients, not being treated with ACE inhibitors, using AN69, cuprophane, and polysulfone membranes. Bradykinin was measured after extraction by radioimmunoassay. During this study one episode of anaphylaxis occurred during dialysis with the AN69 membrane. Blood samples were collected during the first 5 min of the adverse reaction and showed a more than 100-fold increase in the venous effluent of the AN69 dialyzer (baseline 40 ± 3 vs. 4,900 ± 130 fmol/ml after 5 min). Even though none of the patients received ACE inhibitors, there were 4 more asymptomatic individuals who displayed a more than two-fold increase in their plasma bradykinin concentrations in the venous effluent of the AN69 dialyzer. When these patients were treated either with cuprophane or with polysulfone dialyzers, no significant bradykinin formation was detected, nor were there any adverse events. Taken together, these findings show that anaphylactoid reactions with the AN69 membrane are due to excessive bradykinin generation which even may occur in the absence of ACE inhibitors.

© 1993 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Clinical Study

Received: August 03, 1993
Accepted: September 23, 1993
Published online: October 28, 2008
Issue release date: 1993

Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 0

ISSN: 0250-8095 (Print)
eISSN: 1421-9670 (Online)

For additional information: http://www.karger.com/AJN


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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