title: Use of peritoneal dialysis in the treatment of patients with renal failure and paraproteinemia.
abstract: The effect of alterations in dwell time, dialysate dextrose concentration, and nitroprusside on immunoglobulin removal during peritoneal dialysis and a comparison of plasmapheresis versus peritoneal dialysis on immunoglobulin removal was studied. 1 h of plasmapheresis removed approximately 100 times as much IgG and 50 times as much IgM and IgA as 1 h of peritoneal dialysis. Nitroprusside added to peritoneal dialysate doubled the hourly removal rate of IgG using 1- and 8-hour cycles and increased IgA and IgM removal by 25 and 10%, respectively, using 8-hour cycles. It was estimated that peritoneal dialysis with nitroprusside added to peritoneal dialysate augments intact immunoglobulin clearance (above endogenous clearance) by approximately 10%. We hypothesized that peritoneal dialysis could significantly increase light-chain removal and thereby may be efficacious in the treatment of light chain related amyloid formation and light chain induced renal failure.
mesh_terms: D000328:Adult; D000686:Amyloidosis / Q000150:complications / Q000628:therapy; D005069:Evaluation Studies as Topic; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000302:isolation & purification; D007136:Immunoglobulins / Q000302:isolation & purification; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000628:therapy; D009599:Nitroprusside; D010265:Paraproteinemias / Q000150:complications / Q000628:therapy*; D010530:Peritoneal Dialysis / Q000379:methods; D010956:Plasmapheresis; D013997:Time Factors
chemical_list: D007147:Immunoglobulin Light Chains; D007136:Immunoglobulins; D009599:Nitroprusside