Role of proteases in patients with acute renal failure and regular hemodialysis therapy

The potential role of proteases in patients with acute renal failure and regular hemodialysis therapy was investigated. Proteases released from blood cells, damaged kidney cortex and different strains of Pseudomonas aeruginosa in patients with septicemia may contribute to an accelerated protein catabolism. The imbalance of the protease-antiprotease system suggests the valve of active antiproteolytic agents in the treatment of these pathologic states. Our own observation of an in vitro suppression of enhanced proteolysis by the administration of alpha 2-macroglobulin seems to support the usefulness of such a procedure (W.H. H?rl, C. Gautert, I.O. Auer et al., Am. J. Nephrol., 2 (1982) 32-35). As long as alpha 2-macroglobulin is not available, the value of its treatment has to be confirmed by the administration of fresh frozen plasma containing alpha 2-macroglobulin. Also the search for other active antiproteolytic agents is required.