Membrane Flux Not Biocompatibility Determines Beta-2-Microglobulin Levels in Hemodialysis PatientsPickett T.M.a · Cruickshank A.b · Greenwood R.N.b · Taube D.c · Davenport A.d · Farrington K.b
aDirectorate of Medicine, Gloucestershire Royal Hospital, Gloucester; bRenal Unit, Lister Hospital, Stevenage; cRenal and Transplant Unit, St Mary’s Hospital, London, and dCentre for Nephrology, Royal Free Hospital, London, UK
Background: Serum β2-microglobulin (β2M) levels are important in dialysis-related amyloid deposition but can be influenced by dialysis technique. Methods: We measured β2M levels in 3 centres using different dialysis regimes. Centre 1 (73 patients) used high-flux biocompatible, centre 2 (72 patients) low-flux biocompatible and centre 3 (142 patients) cuprophane dialysers. Results: β2M levels were lower with high-flux biocompatible than with low-flux biocompatible or cuprophane dialysis (22.3 ± 5.4 vs. 43.4 ±13.7 and 37.6 ±13.1 mg/l, respectively; p < 0.001). Levels were higher with low-flux biocompatible than with cuprophane dialysis (p < 0.001), but not if patients dialysed over 10 years were excluded. With low-flux biocompatible (47.4 ± 9.8 vs. 38.7 ± 15.2 mg/l; p < 0.01) and cuprophane dialysis (43.4 ± 8.2 vs. 36.7 ± 13.0 mg/l; p < 0.02), β2M levels were higher in patients dialysed over 5 years than in those dialysed less. Despite β2M levels increasing as residual renal function declined, there was no similar rise with high-flux biocompatible dialysis. Conclusions: Techniques allowing significant convection maintain lower β2M levels over many years. Membrane flux, not biocompatibility, is the main determinant of β2M levels in routine practice.
© 2002 S. Karger AG, Basel
Dr. Ken Farrington
Stevenage, Herts SG1 4AB (UK)
Fax +44 1438 781174, E-Mail KenFarring@aol.com
Accepted: August 6, 2001.
Number of Print Pages : 6
Number of Figures : 2, Number of Tables : 1, Number of References : 31
Blood Purification (Official Journal of the International Society of Blood Purification (ISBP))
Founded 1983; edited by K. Schaefer (1983–1988)
Official Journal of the International Society of Blood Purification
Vol. 20, No. 2, Year 2002 (Cover Date: 2002)
Journal Editor: L.W. Henderson, McGaw Park, Ill.
ISSN: 0253–5068 (print), 1421–9735 (Online)
For additional information: http://www.karger.com/journals/bpu