Beta2-microglobulin and phosphate clearances using a wearable artificial kidney: a pilot study.
BACKGROUND
Additional small-solute clearances during standard thrice-weekly hemodialysis treatments have not improved patient survival. However, these treatments have limited middle-molecule clearances. Thus, newer therapies designed to increase middle-molecule clearances need to be developed and evaluated.


METHODS
Pilot clinical trial to measure beta(2)-microglobulin and phosphate clearances with a wearable hemodialysis device.


METHODS
8 regular hemodialysis patients under the care of a university teaching hospital.


METHODS
Patients were fitted with a wearable hemodialysis device for 4 to 8 hours.


RESULTS
All patients tolerated the treatment.


RESULTS
Average amount of beta(2)-microglobulin removed was 99.8 +/- 63.1 mg, with mean clearance of 11.3 +/- 2.3 mL/min, and an average of 445.2 +/- 326 mg of phosphate was removed, with mean plasma phosphate clearance of 21.7 +/- 4.5 mL/min. These clearances compared favorably with mean urea and creatinine plasma clearances (21.8 +/- 1.6 and 20.0 +/- 0.8 mL/min, respectively).


CONCLUSIONS
Proof-of-concept preliminary trial. Additional studies are warranted to confirm these positive preliminary data.


CONCLUSIONS
This wearable artificial kidney potentially provides effective beta(2)-microglobulin and phosphate clearances and, by analogy, middle-molecule clearances.
Cedars Sinai Medical Center, UCLA, The David Geffen School of Medicine, Los Angeles, CA, USA. vgura@cs.com
Victor
V
Gura
Andrew
A
Davenport
Masoud
M
Beizai
Carlos
C
Ezon
Claudio
C
Ronco
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000628:therapy*; D007688:Kidneys, Artificial; D008297:Male; D008875:Middle Aged; D010710:Phosphates / Q000097:blood*; D010865:Pilot Projects; D014508:Urea / Q000097:blood; D001613:beta 2-Microglobulin / Q000097:blood*
D010710:Phosphates; D001613:beta 2-Microglobulin; D014508:Urea; D003404:Creatinine