High-Flux Hemodialysis Postpones Clinical Manifestation of Dialysis-Related AmyloidosisKüchle C. · Fricke H. · Held E. · Schiffl H.
Section of Nephrology, Department of Internal Medicine, Klinikum Innenstadt, University of Munich, Germany
Amyloidosis due to the retention of β2-microgιobulin (β2-MG) is a frequent complication of hemodialysis (HD). Significant amounts of β2-MG can be removed from the body by highly permeable HD membranes, whereas conventional low-flux membranes are impermeable for the molecule. In a prospective and controlled study we investigated whether high-flux HD could delay the onset of dialysis-related amyloidosis (DRA). Twenty patients treated with cuprophane low-flux HD membranes were matched for age and previous time on HD either to continue their HD regimen or to receive HD treatment with high-flux polysulfone membranes. For 6 years each patient was examined for manifestations of DRA once a year or upon individual needs, additionally, serum β2-MG levels were monitored. After 6 years of follow-up no clinical signs of DRA were found in any of the patients dialyzed with high-flux polysulfone membranes, whereas 8/10 of the conventionally dialyzed patients had CTS and/or osteoarticular lesions. Serum levels of β2-MG were significantly reduced in patients treated with high-flux polysulfone membranes.
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