High-flux hemodialysis postpones clinical manifestation of dialysis-related amyloidosis.
Amyloidosis due to the retention of beta 2-microglobulin (beta 2-MG) is a frequent complication of hemodialysis (HD). Significant amounts of beta 2-MG can be removed from the body by highly permeable HD membranes, whereas conventional low-flux membranes are impermeable for the molecule. In a prospective and controlled study we investigated whether high-flux HD could delay the onset of dialysis-related amyloidosis (DRA). Twenty patients treated with cuprophane low-flux HD membranes were matched for age and previous time on HD either to continue their HD regimen or to receive HD treatment with high-flux polysulfone membranes. For 6 years each patient was examined for manifestations of DRA once a year or upon individual needs, additionally, serum beta 2-MG levels were monitored. After 6 years of follow-up no clinical signs of DRA were found in any of the patients dialyzed with high-flux polysulfone membranes, whereas 8/10 of the conventionally dialyzed patients had CTS and/or osteoarticular lesions. Serum levels of beta 2-MG were significantly reduced in patients treated with high-flux polysulfone membranes.
Küchle
C
C
Department of Internal Medicine, Klinikum Innenstadt, University of Munich, Germany.
Fricke
H
H
Held
E
E
Schiffl
H
H
D000328:Adult; D000368:Aged; D000686:Amyloidosis / Q000175:diagnosis / Q000209:etiology*; D001845:Bone Cysts / Q000175:diagnosis / Q000209:etiology; D002349:Carpal Tunnel Syndrome / Q000209:etiology; D002482:Cellulose / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis / Q000209:etiology; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D011108:Polymers; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D013450:Sulfones; D001613:beta 2-Microglobulin / Q000032:analysis
D008567:Membranes, Artificial; D011108:Polymers; D013450:Sulfones; D001613:beta 2-Microglobulin; C017662:polysulfone P 1700; D002482:Cellulose; C009865:cuprammonium cellulose