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Influence of various hemodialysis membranes on the plasma (1-->3)-beta-D-glucan level

H Kanda1, K Kubo, K Hamasaki

  • 1Department of Internal Medicine, University of Tokyo, Tokyo, Japan. hkanda-tky@umin.ac.jp

Kidney International
|June 26, 2001
PubMed
Abstract

Insights

Plasma (1-->3)-beta-D-glucan levels increase with cellulose (Cu) hemodialysis membranes, suggesting these should be avoided in patients with suspected fungal infections. The diagnostic marker’s half-life is approximately 20 hours.

Area of Science:

  • Clinical Chemistry
  • Nephrology
  • Mycology

Background:

  • Invasive fungal infections are rising in immunocompromised individuals.
  • Plasma (1-->3)-beta-D-glucan is a proposed diagnostic marker for deep mycosis.
  • Hemodialysis (HD) may affect (1-->3)-beta-D-glucan levels in end-stage renal disease (ESRD) patients.

Purpose of the Study:

  • To analyze plasma (1-->3)-beta-D-glucan concentration changes using different hemodialysis membranes in ESRD patients.
  • To estimate the half-life of plasma (1-->3)-beta-D-glucan.

Main Methods:

  • Twenty-seven ESRD patients (median age 66) underwent HD with cellulose triacetate (CTA), cellulose (Cu), or polymethyl methacrylate (PMMA) membranes.
  • Plasma (1-->3)-beta-D-glucan was measured before and after each HD session.
  • Half-life was estimated assuming exponential decline.

Main Results:

  • No significant change in (1-->3)-beta-D-glucan levels with CTA or PMMA membranes.
  • A significant increase in (1-->3)-beta-D-glucan levels after HD with Cu membrane (median 9.4 to 332 pg/mL).
  • Estimated median half-life of plasma (1-->3)-beta-D-glucan is 20 hours, independent of hepatic or renal function.

Conclusions:

  • Hemodialyzers with Cu membranes should be avoided in ESRD patients with suspected deep mycosis due to dramatic (1-->3)-beta-D-glucan level increases.
  • Plasma (1-->3)-beta-D-glucan measurement is valuable for patients with hepatic or renal failure.
  • The study highlights the impact of dialysis membrane material on diagnostic marker levels.

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