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The double polymethylmethacrylate filter (DELETE system) in the removal of light chains in chronic dialysis patients

Antonio Santoro1, Michele Grazia, Elena Mancini

  • 1Division of Nephrology, Dialysis and Hypertension, Policlinico S Orsola-Malpighi, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. antonio.santoro @ aosp.bo.it

Blood Purification
|May 17, 2013
PubMed

Insights

The DELETE system, using dual polymethylmethacrylate (PMMA) dialysis filters, effectively removes free light chains (FLC) in multiple myeloma patients. This method aids kidney function recovery while ensuring adequate dialysis, offering a cost-effective treatment option.

Area of Science:

  • Nephrology
  • Hematology
  • Biomedical Engineering

Background:

  • Multiple myeloma (MM) is a common hematological malignancy with a poor prognosis.
  • Acute kidney failure frequently complicates MM, increasing mortality risk.
  • Extracorporeal removal of free light chains (FLC) is being explored to improve renal function in MM patients.

Purpose of the Study:

  • To evaluate the efficacy of a novel double-filter dialysis system using polymethylmethacrylate (PMMA) membranes for FLC removal.
  • To assess the system's ability to provide adequate dialysis treatment concurrently with FLC clearance.

Main Methods:

  • Implementation of the DELETE system, a sequential dialysis procedure utilizing two PMMA dialysis filters (Toray BK-F) with high adsorptive capacity.
  • Evaluation of FLC reduction and standard dialysis adequacy parameters (Kt/V).
  • Measurement of reduction in urea, creatinine, and β2-microglobulin levels.

Main Results:

  • The DELETE system demonstrated satisfactory FLC removal.
  • Adequate dialysis treatment was achieved, with Kt/V values exceeding 1.5.
  • Significant reductions in urea, creatinine, and β2-microglobulin were observed.

Conclusions:

  • The dual PMMA filter DELETE system is a promising approach for FLC removal in patients with multiple myeloma or monoclonal gammopathies on chronic dialysis.
  • This system offers an acceptable cost/efficiency ratio compared to other extracorporeal techniques.
  • It facilitates FLC clearance while maintaining effective dialysis, potentially improving renal outcomes.

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