- 期刊
- OpenAccess
Comparison of the Efficiency of Beta2-Microglobulin Removal in Conventional High-Flux Hemodialysis and Hemodiafiltration
傳統高透量血液透析術與血液透析過濾術對於貝他乙型微球蛋白清除率的比較
摘要
Dialysis-related amyloidosis has been well documented in chronic hemodialysis patients, and leads to carpal tunnel syndrome and various arthropathies. It is well established that beta2-microglobulin (β2M), a key amyloidogenic factor, causes dialysis-related amyloidosis. The present study was undertaken to investigate any differences in the efficiency of removing serum β2M between conventional high-flux hemodialysis (HD) and hemodiafiltration (HDF) in stable, chronic hemodialysis patients. Eight end-stage renal disease patients with chronic hemodialysis were studied. Blood samples were drawn at the beginning and at the end of HD and HDF treatments. However, dialysate samples were collected each hour. The reduction rates and clearances of serum β2M, as well as those of three other small molecules (blood urea nitrogen, creatinine, and phosphorus), were measured. The mean predialysis serum β2M level of 45.0 ± 10.7mg/L in our patients was markedly elevated. The reduction rate of β2M was significantly greater with HDF than with HD treatment (83.1% ± 5.4% vs 75.5% ± 4.5%, p＜0.01). The clearance of β2M was also significantly higher with HDF than with HD treatment (128.0 ± 8.3 vs 97.4 ± 5.8ml/min，p＜0.0001). There were also statistically significant greater clearances for the three small molecules with HDF treatment. In conclusion, our results demonstrate that HDF provides a better reduction rate and clearance for the efficient removal of β2M in chronic hemodialysis patients. Significantly superior clearances of BUN, creatinine, and phosphorus were also noted. Treatment with HDF offers good removal of both small and large molecules.
並列摘要
Dialysis-related amyloidosis has been well documented in chronic hemodialysis patients, and leads to carpal tunnel syndrome and various arthropathies. It is well established that beta2-microglobulin (β2M), a key amyloidogenic factor, causes dialysis-related amyloidosis. The present study was undertaken to investigate any differences in the efficiency of removing serum β2M between conventional high-flux hemodialysis (HD) and hemodiafiltration (HDF) in stable, chronic hemodialysis patients. Eight end-stage renal disease patients with chronic hemodialysis were studied. Blood samples were drawn at the beginning and at the end of HD and HDF treatments. However, dialysate samples were collected each hour. The reduction rates and clearances of serum β2M, as well as those of three other small molecules (blood urea nitrogen, creatinine, and phosphorus), were measured. The mean predialysis serum β2M level of 45.0 ± 10.7mg/L in our patients was markedly elevated. The reduction rate of β2M was significantly greater with HDF than with HD treatment (83.1% ± 5.4% vs 75.5% ± 4.5%, p＜0.01). The clearance of β2M was also significantly higher with HDF than with HD treatment (128.0 ± 8.3 vs 97.4 ± 5.8ml/min，p＜0.0001). There were also statistically significant greater clearances for the three small molecules with HDF treatment. In conclusion, our results demonstrate that HDF provides a better reduction rate and clearance for the efficient removal of β2M in chronic hemodialysis patients. Significantly superior clearances of BUN, creatinine, and phosphorus were also noted. Treatment with HDF offers good removal of both small and large molecules.