Abstract: FR-PO0538
Cardiovascular Morbidity and Mortality in Hemodialysis: In Addition to Traditional Risk Factors, Chronic Inflammation, Complement Activation, and Biocompatibility Are Also in Focus
Session Information
- CKM: Clinical - Trials, Epidemiology, and Biomarkers
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Cardiovascular-Kidney-Metabolic Health
- 602 Cardiovascular-Kidney-Metabolic Health: Clinical
Author
- Petho, Akos, Semmelweis Egyetem, Budapest, Hungary
Background
Chronic kidney disease (CKD) is a significant global health issue. Hemodialysis reactions (HDRs) are similar to hypersensitivity reactions linked to complement activation during nanoparticle infusions. Ongoing inflammation during HD may increase the risk of cardiovascular mortality.
Methods
We measured biomarkers associated with Complement Activation Related Pseudoallergy (CARPA), including pulmonary arterial pressure (PAP), blood cell counts, and plasma sC5b-9 and thromboxane B2 (TXB2) in human and animal HD models. In humans, PAP was estimated noninvasively using plasma NT-proBNP concentration.
Results
In the animal model, a steady rise of sC5b-9 was found. Notably, small changes in baseline PAP and plasma thromboxane-B2 levels during hemodialysis led to sharp increases of 30-70% across all groups, resulting in spikes within minutes of blood reinfusion (Figure 1). In humans, increased levels of NT-proBNP and TXB2 were measured during reinfusion, with C3a rising early in HD and remaining elevated through the end of reinfusion (Figure 2).
Conclusion
Patients undergoing HD experience heightened inflammation due to the nature of the HD technique. This elevated inflammatory response may be associated with the non-biocompatible environment during HD, which may explain the increased cardiovascular complications observed.
sC5b-9 levels during hemodialysis and after a zymosan bolus. NSF denotes the Nipro SureFlux-15UX membrane, FXC the Fresenius FX CorDiax 40, and DES the dialysis exchange set without a filter.
C3a levels increased significantly from the start of hemodialysis. NT-proBNP levels decreased significantly during hemodialysis (p<0.001) and rose after reinfusion (p<0.05).