All available dialysis membranes prevent endotoxin (Et) from mixing with the blood under clinical conditions. However, maintenance dialysis patients are at risk of amyloidosis attributed to Et. This suggests that Et may affect the blood even if it does not mix with the blood. The objective of the present study is to evaluate the activity of Et trapped by membranes. We made mini modules out of hollow fibers using three different types of membranes and filtered Et solution. The lumen of the hollow fibers was then filled with limulus amebocyte lysate (LAL) for 15 min at 310 K. Et activity was then determined by measuring absorbance of the LAL reagent. The surfaces of test membranes were studied using an atomic force microscope. With polyester polymer alloy (PEPA), no Et leakage or Et activity was detected in the hollow fibers under any conditions. With polysulfone (PS) and polyether sulfone (PES), no Et leakage was detected under clinical conditions, but Et activity was detected in the hollow fibers. These results show that Et trapped by the inner skin may affect the blood, even if Et does not mix with the blood. Therefore, Et should be trapped by an outer skin or the part somewhat far from the blood which does not contact with the blood directly.
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