Beta2-microglobulin.
Among the uremic toxins in the "middle molecule" range, beta2-microglobulin (beta2-M) is certainly one of the most frequently studied compounds. Its serum level increases with the progression of chronic kidney disease, to reach very high concentrations in patients with end-stage kidney disease. It is the major protein component of dialysis-related amyloidosis, a dramatic complication which results from high extracellular concentration and posttranslational modification of beta2-M and a number of other promoters of amyloid fibril formation and deposition in osteo-articular tissues. Effective removal of beta2-M can be achieved with highly effective hemodialysis and hemodiafiltration techniques but predialysis session serum levels cannot be normalized. The prevalence and severity of beta2-M amyloidosis appear to have decreased in the last 20 years, although its occurrence may simply be delayed.
Drüeke
Tilman B
TB
Inserm Unit 845, Necker Medical School, University Paris-Descartes, Paris, France. tilman.drueke@inserm.fr
Massy
Ziad A
ZA
D000686:Amyloidosis / Q000209:etiology / Q000378:metabolism / Q000628:therapy; D015415:Biomarkers / Q000378:metabolism; D006801:Humans; D007674:Kidney Diseases / Q000150:complications / Q000378:metabolism / Q000628:therapy*; D006435:Renal Dialysis; D016896:Treatment Outcome; D001613:beta 2-Microglobulin / Q000502:physiology*
D015415:Biomarkers; D001613:beta 2-Microglobulin