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Beta 2-microglobulin elimination characteristics during hemofiltration with acrylonitrile and polysulfone membrane
A Kandus1, R Ponikvar, J Drinovec
1Department of Nephrology, University Medical Center, Ljubljana, Yugoslavia.
Abstract:
Elimination characteristics of beta 2-microglobulin (BMG) during hemofiltration (HF) with acrylonitrile (AN69) and polysulfone (PS) hemofilters were investigated in a prospective clinical investigation. Seven chronic uremics on regular HF were treated for 4 weeks, three times a week, with AN69 hemofilters. The study was then repeated with PS hemofilters. There were no significant differences in the patients' body weight, the ultrafiltrate volume per session, and the duration of each HF session between both treatments. At the start of HF, arterial plasma concentration of BMG was (for AN69) 33.5 +/- 4.0 mg/L (mean +/- SD) and (for PS) 35.8 +/- 6.5 mg/L (NS); at the end of HF it was (for AN69) 11.0 +/- 1.8 mg/L and (for PS) 17.5 +/- 4.2 mg/L (p less than 0.001). The amount of BMG in total ultrafiltrate was (for AN69) 179.3 +/- 22.6 mg and (for PS) 140.6 +/- 26.8 mg (p less than 0.02). With AN69 hemofilter, maximum BMG plasma clearance and sieving coefficient were 51.0 +/- 9.5 mL/min and 0.42 +/- 0.04 at 60 minutes. With PS hemofilter, maximum BMG plasma clearance and sieving coefficient were 37.4 +/- 5.7 mL/min and 0.27 +/- 0.03 at 15 minutes. Twenty-two percents of BMG entering the AN69 hemofilter at 15 minutes were adsorbed on the membrane (p less than 0.001). BMG elimination with the AN69 hemofilter was more efficient than with the PS hemofilter. Long-term studies will be necessary to demonstrate whether this difference is of any clinical significance.
Insights
Acrylonitrile (AN69) hemofilters demonstrated superior elimination of beta 2-microglobulin (BMG) compared to polysulfone (PS) hemofilters in chronic uremic patients. AN69 filters showed higher BMG clearance and sieving coefficients, indicating more efficient toxin removal.
Area of Science:
- Nephrology
- Biomedical Engineering
- Clinical Investigation
Background:
- Beta 2-microglobulin (BMG) is a protein that accumulates in patients with chronic kidney disease.
- Hemofiltration is a common dialysis technique used to remove waste products from the blood.
- Different hemofilter membranes may have varying efficiencies in removing specific solutes like BMG.
Purpose of the Study:
- To compare the elimination characteristics of beta 2-microglobulin (BMG) using acrylonitrile (AN69) and polysulfone (PS) hemofilters.
- To evaluate the efficiency of BMG removal during hemofiltration in chronic uremic patients.
Main Methods:
- A prospective clinical investigation involving seven chronic uremic patients undergoing regular hemofiltration.
- Patients were treated sequentially with AN69 and PS hemofilters for 4-week periods.
- Key parameters measured included BMG plasma concentrations, ultrafiltrate volume, BMG elimination, plasma clearance, and sieving coefficients.
Main Results:
- Arterial BMG concentrations were significantly reduced by both AN69 and PS hemofilters by the end of treatment (p < 0.001).
- AN69 hemofilters showed significantly higher BMG elimination in the ultrafiltrate (p < 0.02) and greater BMG adsorption onto the membrane (p < 0.001).
- Maximum BMG plasma clearance and sieving coefficients were higher and achieved faster with AN69 hemofilters compared to PS hemofilters.
Conclusions:
- The AN69 hemofilter demonstrated more efficient elimination of beta 2-microglobulin compared to the PS hemofilter.
- The findings suggest AN69 hemofilters may offer an advantage in removing BMG during hemofiltration.
- Further long-term studies are needed to determine the clinical significance of this observed difference in BMG elimination.