Relationship between formaldehyde-related antibodies and cross-reacting anti-N-like antibodies in patients undergoing chronic haemodialysis.

An attempt was made to determine the sequence of events leading to the production of two distinct antibodies in patients with chronic renal failure who regularly undergo haemodialysis with formaldehyde-resterilizable dialysis units by Multipoint (UK) or Cordis (USA). A distinct pattern emerged-namely, the production of anti-formaldehyde red cells started about six months after the beginning of haemodialysis treatment. Only when the titre of these antibodies reached 64 or 128 another, apparently cross-reacting, antibody appeared which reacted like an anti-N antibody. A strong direct antiglobulin reaction was found to be positive for formalin-treated red cells after five minutes' contact with specific antibody, indicating a high affinity of the antibody fo the formalin-altered red cell.