A new therapeutic approach to dialysis amyloidosis: intensive removal of beta 2-microglobulin with adsorbent column.
Amyloidosis, in which amyloid protein consists of beta 2-microglobulin (beta 2-M), is both a common and a serious complication of long-term hemodialysis. The mechanism of its development is not completely understood. Since beta 2-M is an amyloid protein, it is essential to try to remove as much of it as possible. A specific adsorbent of beta 2-M has been developed for use in direct hemoperfusion. The adsorbent is a porous cellulose bead to which hydrophobic organic compound is bound covalently. A combination of a high-flux membrane dialyzer and an adsorption column (BM-01) would make it possible to efficiently eliminate beta 2-M. Dialysis with a combination of direct hemoperfusion (DHP) and an adsorption column led to the elimination of more than 200-300 mg of beta 2-M. We observed 5 patients who received treatment with this column (BM-01) in combination with high-flux dialysis 3 times a week for periods of 1 week (3 patients), 6 months (1 patient), or 14 months (1 patient). It is demonstrated that the adsorbent column (BM-01) provides an intensive method to eliminate beta 2-M from the blood with no serious adverse effect. It thus has the potential to suppress the progression of dialysis amyloidosis. The use of this adsorbent column (BM-01) in combination with a high-flux dialyzer may present an improved approach to removing beta 2-M from the body.
Department of Internal Medicine (II), Niigata University School of Medicine, Japan.
F
F
Gejyo
N
N
Homma
S
S
Hasegawa
M
M
Arakawa
D000327:Adsorption; D000686:Amyloidosis / Q000209:etiology* / Q000628:therapy*; D001168:Arthritis / Q000209:etiology; D002349:Carpal Tunnel Syndrome / Q000209:etiology; D005260:Female; D005921:Glomerulonephritis / Q000628:therapy; D006464:Hemoperfusion; D006801:Humans; D007688:Kidneys, Artificial; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects* / Q000379:methods; D001613:beta 2-Microglobulin
D008567:Membranes, Artificial; D001613:beta 2-Microglobulin