A new treatment for dialysis-related amyloidosis with beta 2-microglobulin adsorbent column.
Dialysis-related amyloidosis (DRA) is characterized by the presence of beta 2-microglobulin (beta 2-m) in the plasma. In order to eliminate beta 2-m from the circulating blood, the beta 2-m selective adsorbent for direct hemoperfusion (DHP) was developed. A DHP column (BM-01), containing 350 ml of the adsorbent, was subjected to clinical trials. The column was connected with a PAN (AN69) membrane dialyzer in series and used 3 times a week for 1 week (11 patients), 4 weeks (5 patients), 6 months (1 patient) and 12 months (2 patients). The percent reduction (%) of beta 2-m was for 16 patients (for 1 or 4 weeks), more than 65, and for 3 patients (for more than 6 months), 76.5 +/- 4.9, 73.5 +/- 5.7, 72.2 +/- 6.2. At the end of each session, beta 2-m plasma levels were found to be below 10 mg/L, with 3.4 mg/L being the lowest. The total amounts of beta 2-m removed were 172.5 +/- 22.3, 257.0 +/- 75.6, 157.6 +/- 32.2 and 429.8 mg/session at max. Two out of these three patients had a favorable effect on joint symptoms and ocular fundus. It can be concluded that this selective adsorption therapy may delay the progression of DRA, and is worth considering for wide application.
Nakazawa
R
R
Tokatsu Clinic Hospital, Matsudo, Japan.
Azuma
N
N
Suzuki
M
M
Nakatani
M
M
Nankou
T
T
Furuyoshi
S
S
Yasuda
A
A
Takata
S
S
Tani
N
N
Kobayashi
F
F
D000327:Adsorption; D000328:Adult; D000368:Aged; D000686:Amyloidosis / Q000097:blood / Q000209:etiology / Q000628:therapy*; D005260:Female; D006464:Hemoperfusion / Q000295:instrumentation / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*; D001613:beta 2-Microglobulin / Q000032:analysis
D001613:beta 2-Microglobulin