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The effect of hollow-fiber dialyzer Plivadial Altra-Flux 140 on beta-2-microglobulin removal
P Kes1, A Zubcić, I Ratković-Gusić
1Department of Nephrology and Dialysis, Sestre Milosrdnice University Hospital, Zagreb, Croatia.
Abstract:
A thirty-fold or even greater increase in plasma beta-2-microglobulin (beta 2M), which is commonly found in end-stage renal disease (ESRD) patients on long-term hemodialysis (HD), is most likely a consequence of the inability of the dialysis procedure to remove the dally production of beta 2M. In the present study, a newly developed high-flux membrane composed of cellulose diacetate (CDA) (dialyzer Plivadial Altra-Flux 140, Pliva, Zagreb, Croatia) was evaluated with regard to beta 2M removal capacity during HD in 8 stable ESRD patients. Thera was a drop in the plasma beta 2M concentration (-19.8 +/- 8.4) with a clearance of 22.7 +/- 9.2 ml/min (QB = 250 ml/min, QD = 600 ml/min). Accordingly, the sieving coefficient (SC) was found to be 0.37 +/- 0.1 at 60 min after the start of HD. The CDA membrane was able to remove 100.5 +/- 30 mg of beta 2M during a 4-hour HD session. This data demonstrate an increased percentage removal of beta 2M and significantly decreased postdialysis plasma concentrations of beta 2M which is a potential factor in the development of dialysis-related amyloidosis (DRA).
Insights
A new high-flux cellulose diacetate membrane effectively removes beta-2-microglobulin (beta 2M) during hemodialysis. This improved removal in end-stage renal disease patients may help prevent dialysis-related amyloidosis.
Area of Science:
- Nephrology
- Biomaterials Science
Background:
- Elevated plasma beta-2-microglobulin (beta 2M) is common in end-stage renal disease (ESRD) patients undergoing long-term hemodialysis (HD).
- This increase is likely due to the limited capacity of conventional dialysis to clear daily beta 2M production.
Purpose of the Study:
- To evaluate the beta 2M removal capacity of a novel high-flux cellulose diacetate (CDA) membrane during hemodialysis.
- To assess the impact of this membrane on postdialysis beta 2M concentrations in stable ESRD patients.
Main Methods:
- A new high-flux CDA membrane (Plivadial Altra-Flux 140) was used in 8 stable ESRD patients undergoing HD.
- Plasma beta 2M concentrations, clearance, sieving coefficient (SC), and total beta 2M removed were measured.
Main Results:
- A significant drop in plasma beta 2M concentration was observed (-19.8 +/- 8.4).
- The membrane demonstrated a beta 2M clearance of 22.7 +/- 9.2 ml/min with a sieving coefficient of 0.37 +/- 0.1.
- Over a 4-hour HD session, 100.5 +/- 30 mg of beta 2M was removed.
Conclusions:
- The novel CDA membrane shows enhanced beta 2M removal during hemodialysis.
- This improved clearance leads to significantly decreased postdialysis plasma beta 2M levels.
- This finding suggests a potential role in mitigating the development of dialysis-related amyloidosis (DRA).