Removal of beta 2-microglobulin by hemodialysis and hemofiltration: a four year follow up.
Efficient removal of total body burden beta 2-Microglobulin (beta 2-M) in uremia is a continuing challenge, as dialysis-related amyloidosis represents a major complication of chronic renal replacement therapy. To investigate long-term beta 2-M removal we studied 3 groups of stable end-staged renal failure patients over a period of 4 years; we compared low flux (cuprophane) hemodialysis (n = 12), high flux (polysulfone) hemodialysis (n = 12) and hemofiltration using high flux polysulfone (n = 8). In contrast to the cuprophane membrane, the polysulfone membrane eliminated considerable amounts of beta 2-M. This was associated with a sustained reduction of predialysis serum beta 2-M-levels (by 20%). Compared with high flux hemodialysis, hemofiltration provided a 50% higher elimination of beta 2-M. Thus, our long-term evaluation of beta 2-M removal suggests that hemofiltration rather than hemodialysis may be the treatment of choice for delaying the incidence of dialysis-related amyloidosis.
Schiffl
H
H
Medizinische Klinik, Universität München, FRG.
D'Agostini
B
B
Held
E
E
D000328:Adult; D000368:Aged; D000686:Amyloidosis / Q000517:prevention & control; D002482:Cellulose / Q000031:analogs & derivatives; D005260:Female; D006440:Hemofiltration; D006801:Humans; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D011108:Polymers; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000628:therapy; D013450:Sulfones; D001613:beta 2-Microglobulin / Q000032:analysis / Q000302:isolation & purification*
D008567:Membranes, Artificial; D011108:Polymers; D013450:Sulfones; D001613:beta 2-Microglobulin; C017662:polysulfone P 1700; D002482:Cellulose; C009865:cuprammonium cellulose