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Long-term multicentre study on beta 2-microglobulin removal by PMMA BK membrane
1Department of Medicine (II), Niigata University School of Medicine, Japan.
Abstract:
A long-term multi-centre clinical study was performed, based upon our first identification of beta 2-microglobulin (beta 2-M) amyloid fibrils and optimisation of the pore-size of the polymethylmethacrylate (PMMA) membrane for its removal. To clarify the clinical significance of the newly designed PMMA membrane, BK membrane, having an average pore radius of 70-80 Angströms (7-8 nm), a total of 73 chronic haemodialysis patients from 28 centres, classified into four groups, were studied. Although the plasma beta 2-M decreased in all groups through the continued use of BK membrane, the early introduction of haemodialysis with BK membrane reduced the plasma concentration of this substance more than in the case of the later introduction. Pain index, defined as the total pain score divided by the number of painful joints, decreased significantly over the period of haemodialysis duration with BK membrane. This suggests that the continued use of BK membrane from the early phase of haemodialysis treatment results in the amelioration and/or prevention of joint pains of haemodialysis patients as well as preventing the increase in plasma beta 2-M.
Insights
Early use of the novel BK membrane in hemodialysis significantly reduces beta 2-microglobulin (beta 2-M) and joint pain. This optimized polymethylmethacrylate membrane prevents beta 2-M accumulation and associated pain in chronic kidney disease patients.
Area of Science:
- Nephrology
- Biomaterials Science
- Clinical Medicine
Background:
- Beta 2-microglobulin (beta 2-M) amyloidosis is a complication of chronic kidney disease.
- Polymethylmethacrylate (PMMA) membranes are used in hemodialysis.
- Optimizing PMMA membrane pore size is crucial for effective beta 2-M removal.
Purpose of the Study:
- To evaluate the clinical significance of a newly designed PMMA membrane (BK membrane) for beta 2-M removal.
- To assess the impact of early versus late introduction of BK membrane hemodialysis on beta 2-M levels and joint pain.
- To determine the long-term efficacy of the BK membrane in chronic hemodialysis patients.
Main Methods:
- A long-term, multi-center clinical study involving 73 chronic hemodialysis patients across 28 centers.
- Patients were divided into four groups based on the timing of BK membrane introduction.
- Plasma beta 2-M concentrations and pain index were monitored throughout the study.
Main Results:
- Plasma beta 2-M levels decreased in all groups using the BK membrane.
- Early introduction of BK membrane hemodialysis led to a greater reduction in plasma beta 2-M compared to later introduction.
- The pain index significantly decreased with continued use of the BK membrane, indicating amelioration of joint pain.
Conclusions:
- Early initiation of hemodialysis with the BK membrane effectively reduces plasma beta 2-M concentrations.
- The BK membrane demonstrates efficacy in ameliorating and potentially preventing joint pain associated with hemodialysis.
- Optimized PMMA membrane technology offers a promising approach for managing beta 2-M related complications in chronic hemodialysis patients.