Transmembranous transport and adsorption of beta-2-microglobulin during hemodialysis using polysulfone, polyacrylonitrile, polymethylmethacrylate and cuprammonium rayon membranes.
Beta-2-microglobulin (b2M) was identified as a causative agent of amyloidosis associated with long-term hemodialysis (HD). Therefore, we examined handling of b2M during a 4-hour hemodialysis session. We compared b2M adsoprtion and diffusive/convective elimination between high-flux membranes such as polysulfone (PS; F 60, Fresenius), polyacrylonitrile (AN 69; Filtral, Hospal) and polyacrylonitrile (PAN, PAN 12CX2, Asahi) and less permeable membranes such as cuprammonium rayon (CR; AM 160 H, Asahi) and polymethylmethacrylate (PMMA; BK-1.6 U, Toray). To calculate total elimination, arterio-venous differences of b2M were measured at 0, 5, 20, 60 and 240 minutes; dialysate concentration was analyzed to evaluate diffusive/convective transport. Differences between recovery in dialysate and total removal were regarded as amount removed by adsorption. Total elimination per 4-hour hemodialysis session and per m2 membrane surface was 154.7 +/- 12.3 mg for the PS, 137.8 +/- 28.4 mg for the AN 69, 179.8 +/- 47.5 mg for the PAN, 130.8 +/- 11.8 mg for the PMMA and 14.4 +/- 16.0 mg for the CR membrane. Diffusive/convective transport was 128.0 +/- 18.1 mg for PS, 54.7 +/- 8.1 mg for AN 69 and 106.5 +/- 20.8 mg for PAN and insignificant for PMMA and CR. Adsorption was 26.7 +/- 4.3 mg for PS, 83.1 +/- 29.0 mg for AN 69 and 59.8 +/- 17.2 mg for PAN. Besides transmembranous transport sorption is an important mode of elimination. Weekly endogenous generation rate is about twice as high as b2M elimination.
Klinke
B
B
Deutsche Klinik für Diagnostik, Department of Nephrology, Wiesbaden, FRG.
Röckel
A
A
Abdelhamid
S
S
Fiegel
P
P
Walb
D
D
D000180:Acrylic Resins; D000327:Adsorption; D000368:Aged; D002482:Cellulose; D015314:Dialysis Solutions / Q000032:analysis; D006801:Humans; D008567:Membranes, Artificial; D008768:Methylmethacrylates; D011108:Polymers; D011863:Radioimmunoassay; D006435:Renal Dialysis; D013450:Sulfones; D001613:beta 2-Microglobulin / Q000032:analysis / Q000493:pharmacokinetics*
D000180:Acrylic Resins; D015314:Dialysis Solutions; D008567:Membranes, Artificial; D008768:Methylmethacrylates; D011108:Polymers; D013450:Sulfones; D001613:beta 2-Microglobulin; C010504:polyacrylonitrile; C017662:polysulfone P 1700; D002482:Cellulose; C012024:rayon, purified