Related Experiment Videos
Red blood cell function and beta 2 microglobulin kinetics during cuprophan hemodialysis: a hypothesis
R L Lins1, P Zachée, R Daelemans
1Department of Nephrology-Hypertension, A.Z. Stuivenberg, Antwerpen, Belgium.
Abstract:
The exact role of beta 2microglobulin (beta 2m) in dialysis amyloidosis is yet not known. Local release of beta 2m from the endothelial cells of the lung and other tissues as a consequence of acute-phase activation due to the contact of blood with membranes has still to be considered a possible pathogenetic factor in this syndrome. beta 2m kinetics and decrease of glutathione content in RBC were studied in 41 chronic hemodialysis patients during cuprophan dialysis. The latter test reflects the RBC scavenger function for free oxygen radicals. Only 30% of patients showed a clinically significant increase in beta 2m. The change in beta 2m in this group between the start and 180 minutes, corrected for plasma volume, was 23.1 +/- 3.6% and the change in gluthathione content between the start and 15 minutes was 4.5 +/- 3.4%. In these patients there was a significant correlation between beta 2m production and decrease of gluthathione (R = -0.61, p = 0.0299). It is possible that the production of free oxygen radicals during bioincompatible dialysis leads to cellular toxicity with release of beta 2m which may be prevented to some extent by the scavenger role of RBC.
Insights
Dialysis amyloidosis involves beta 2-microglobulin (beta 2m). Bioincompatible dialysis may increase beta 2m and decrease red blood cell glutathione, suggesting a link between oxidative stress and beta 2m release.
Area of Science:
- Nephrology
- Biochemistry
- Hematology
Background:
- The precise role of beta 2-microglobulin (beta 2m) in dialysis amyloidosis remains unclear.
- Contact between blood and dialysis membranes may trigger acute-phase reactions, leading to local beta 2m release from endothelial cells.
Purpose of the Study:
- To investigate the kinetics of beta 2m and the changes in red blood cell (RBC) glutathione content during cuprophan dialysis.
- To explore the relationship between beta 2m production and RBC scavenger function.
Main Methods:
- Studied 41 chronic hemodialysis patients undergoing cuprophan dialysis.
- Monitored beta 2m levels and RBC glutathione content (indicating free oxygen radical scavenging).
Main Results:
- A clinically significant increase in beta 2m was observed in 30% of patients.
- In this subgroup, a 23.1% increase in beta 2m (corrected for plasma volume) correlated with a 4.5% decrease in RBC glutathione.
- A significant negative correlation (R = -0.61, p = 0.0299) was found between beta 2m production and glutathione decrease.
Conclusions:
- Bioincompatible dialysis may induce oxidative stress and cellular toxicity, leading to beta 2m release.
- The scavenger function of RBCs might offer partial protection against this beta 2m release.