Effect of beta(2)-microglobulin adsorption column on dialysis-related amyloidosis.
BACKGROUND
beta2-microglobulin (beta2-m) is considered a major pathogenic factor in dialysis-related amyloidosis (DRA), often seen in long-term dialysis patients. No effective therapy for this severely debilitating disease is currently available. Lixelle, an adsorption column, has been developed for the elimination of beta2-m; the efficacy of this column has been evaluated in this study.


METHODS
Seventeen hemodialysis patients with DRA were first treated with high-flux dialysis for a minimum of 1 year. This was followed by 1-year treatment with Lixelle column connected in series to the high-flux dialyzer. Treatments were used three times a week for both phases of this study. During the study period, beta2-m, pinch strength, motor terminal latency, and activities of daily living were evaluated.


RESULTS
After 1-year treatment with high-flux dialysis the beta2-m level remained unchanged; however, after 1-year treatment with the addition of the Lixelle column, beta2-m level decreased significantly from 34.5 +/- 8.4 mg/L to 28.8 +/- 7.3 mg/L (P < 0.05). After 1 year of Lixelle column use, the pinch strength increased from 6.8 +/- 4.7 pounds to 9.1 +/- 5.5 pounds (P < 0.01), and the median motor terminal latency was significantly reduced from 5.1 +/- 1.0 mseconds to 4.5 +/- 1.1 mseconds. A significant improvement was also observed in the activities of daily living score of the upper extremities.


CONCLUSIONS
These results suggest that the addition of Lixelle to the high-flux dialyzer is associated with a significant clinical improvement in DRA patients.
Abe
Takaya
T
Center of Blood Purification Therapy, Wakayama Medical University, Wakayama, Japan. takayabe@hitmark.com
Uchita
Kazuhiro
K
Orita
Hikari
H
Kamimura
Motohiro
M
Oda
Minoru
M
Hasegawa
Hirohito
H
Kobata
Hirotsugu
H
Fukunishi
Masaaki
M
Shimazaki
Masami
M
Abe
Tomiya
T
Akizawa
Tadao
T
Ahmad
Suhail
S
D000327:Adsorption; D000328:Adult; D000368:Aged; D000686:Amyloidosis / Q000097:blood / Q000209:etiology* / Q000628:therapy*; D001781:Blood Component Removal / Q000295:instrumentation* / Q000379:methods*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*; D016896:Treatment Outcome; D001613:beta 2-Microglobulin / Q000378:metabolism*
D001613:beta 2-Microglobulin