PMID- 10607768
OWN - NLM
STAT- MEDLINE
DCOM- 20000224
LR  - 20190513
IS  - 0931-0509 (Print)
IS  - 0931-0509 (Linking)
VI  - 15
IP  - 1
DP  - 2000 Jan
TI  - beta(2)-microglobulin kinetics in nocturnal haemodialysis.
PG  - 58-64
AB  - BACKGROUND: beta(2)-Microglobulin (beta(2)m) is a major component of 
      dialysis-related amyloidosis. The available therapeutic options do not permit 
      normalization of the serum beta(2)m level. In a cross-over trial, we studied the 
      kinetics of beta(2)m during two different dialytic techniques. METHODS: Ten 
      stable, anuric end-stage renal disease patients were studied during two 
      consecutive weeks of three conventional (CHD) and six nocturnal haemodialysis 
      (NHD) sessions. CHD was performed for 4 h three times weekly using a polysulfone 
      dialyser (F80, surface area of 1.8 m(2)) with a mean blood and dialysate flow 
      rate of 401+/-91.6 and 514+/-10.9 ml/min, respectively. The NHD was done with a 
      smaller dialyser (F40, surface area of 0.7 m(2)) and lower blood (281+/-17 
      ml/min) and dialysate flow rates (99+/-1.2 ml/min) for 8 h, six nights a week. 
      RESULTS: Weekly removal of urea (51.6+/-24.6 vs 43.1+/-20.5 g) and creatinine 
      (8501+/-5204 vs 6319+/-4134 mg) were comparable with the two modalities of 
      dialysis but the mass of beta(2)m removed was significantly higher with NHD 
      (127+/-48 vs 585+/-309 mg, P<0.001), with a percentage reduction in serum level 
      of 20.5+/-5.8 vs 38.8+/-7. 1% (P<0.0001) and a Kt/V(beta2m) of 0.21+/-0.09 vs 
      0.56+/-0.17 (P<0. 0006). The mean post-dialysis beta(2)m (20.8+/-6.3 vs 
      14.0+/-3.8 mg/dl, P=0.02), Tac(beta2m) (26.2+/-5.2 vs 19.8+/-3.8 mg/dl, P=0.02) 
      and pre-dialysis beta(2)m (beta(2)m(pre)) at the end of 1 week of therapy 
      (24.4+/-7.6 vs 19.0+/-3.4 mg/dl, P=0.02) were lower with NHD. Long-term follow-up 
      data were available in 13 and seven patients at the end of 1 and 2 years, 
      respectively. Serum beta(2)m(pre) levels progressively declined from 27.2+/-11.7 
      mg/dl at initiation of NHD to 13.7+/-4.4 mg/dl by 9 months, and they remained 
      stable thereafter. CONCLUSIONS: NHD provides a much higher clearance of beta(2)m 
      than CHD, leading to a long-term decrease in the pre-dialysis concentration of 
      beta(2)m.
FAU - Raj, D S
AU  - Raj DS
AD  - Department of Medicine, Louisiana State University Medical Center, Shreveport, 
      Louisiana, USA.
FAU - Ouwendyk, M
AU  - Ouwendyk M
FAU - Francoeur, R
AU  - Francoeur R
FAU - Pierratos, A
AU  - Pierratos A
LA  - eng
PT  - Clinical Trial
PT  - Controlled Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Nephrol Dial Transplant
JT  - Nephrology, dialysis, transplantation : official publication of the European 
      Dialysis and Transplant Association - European Renal Association
JID - 8706402
RN  - 0 (beta 2-Microglobulin)
SB  - IM
MH  - Adult
MH  - Amyloidosis/blood/etiology/prevention & control
MH  - Cross-Over Studies
MH  - Female
MH  - Humans
MH  - Kidney Failure, Chronic/blood/therapy
MH  - Kinetics
MH  - Male
MH  - Middle Aged
MH  - Renal Dialysis/adverse effects/*methods
MH  - Time Factors
MH  - beta 2-Microglobulin/*blood
EDAT- 1999/12/23 09:00
MHDA- 2000/02/26 09:00
CRDT- 1999/12/23 09:00
PHST- 1999/12/23 09:00 [pubmed]
PHST- 2000/02/26 09:00 [medline]
PHST- 1999/12/23 09:00 [entrez]
AID - 10.1093/ndt/15.1.58 [doi]
PST - ppublish
SO  - Nephrol Dial Transplant. 2000 Jan;15(1):58-64. doi: 10.1093/ndt/15.1.58.