Beta2-microglobulin and low-flux synthetic dialyzers.
The aim of this study was to compare the effect on beta2-microglobulin (beta2-M) plasma levels of dialyzers with 3 low-flux synthetic membranes and regenerated cellulose (Cuprophan) in 12 chronic dialysis patients. The synthetic membrane materials chosen were low-flux polymethylmethacrylate (PMMA), low-flux polysulfone (PS 400), and polycarbonate-polyether (Gambrane). Adequate and comparable removal of small solutes was provided by dialyzers with all 4 membrane materials used under similar conditions. A significant reduction of beta2-M plasma levels was seen only with Gambrane while the other 2 synthetic membrane materials gave rise to increases similar to those known to occur with Cuprophan. After correction for the hemoconcentration caused by ultrafiltration, dialysis with Gambrane showed a 24% lower plasma beta2-M level while the beta2-M concentrations with the other 3 membrane materials were practically unchanged. In addition, the efficiency of Gambrane dialyzers in beta2-M removal was able to significantly lower the predialysis plasma beta2-M levels after only 5 dialysis sessions. The hemocompatibility of the 3 synthetic low-flux membranes as judged by the white blood cell (WBC) count and complement activation was similar and therefore cannot be used to explain the different beta2-M plasma levels. In anticipation of gaining further insight into the mechanisms of accumulation and deposition of beta2-M in dialysis patients, a worthwhile approach may be to use a low-flux membrane such as Gambrane which combines removal with protection against potential activating factors in the dialysis fluid.
Klinkmann
H
H
International Faculty for Artificial Organs, University of Strathclyde, Glasgow, Scotland.
Buscaroli
A
A
Stefoni
S
S
D000368:Aged; D000704:Analysis of Variance; D000706:Anaphylatoxins / Q000032:analysis; D001672:Biocompatible Materials / Q000737:chemistry*; D002482:Cellulose / Q000031:analogs & derivatives / Q000737:chemistry; D003167:Complement Activation; D015926:Complement C3a / Q000031:analogs & derivatives / Q000032:analysis; D015314:Dialysis Solutions / Q000737:chemistry; D005260:Female; D006440:Hemofiltration; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008567:Membranes, Artificial; D010710:Phosphates / Q000097:blood; D011108:Polymers / Q000737:chemistry; D019904:Polymethyl Methacrylate / Q000737:chemistry; D006435:Renal Dialysis / Q000295:instrumentation*; D013450:Sulfones / Q000737:chemistry; D014508:Urea / Q000097:blood; D001613:beta 2-Microglobulin / Q000032:analysis* / Q000737:chemistry
D000706:Anaphylatoxins; D001672:Biocompatible Materials; D015314:Dialysis Solutions; D008567:Membranes, Artificial; D010710:Phosphates; D011108:Polymers; D013450:Sulfones; D001613:beta 2-Microglobulin; C044541:complement C3a, des-Arg-(77)-; C017662:polysulfone P 1700; C049723:polycarbonate-polyether copolymer; D015926:Complement C3a; D014508:Urea; D002482:Cellulose; D019904:Polymethyl Methacrylate; C009865:cuprammonium cellulose