Nephrol Dial Transplant (2000) 15: 58-64
© 2000 European Renal Association-European Dialysis and Transplant Association
ß2-Microglobulin kinetics in nocturnal haemodialysis
Department of Medicine, Louisiana State University Medical Center, Shreveport, Louisiana, USA and 1 Nocturnal Hemodialysis Project, Wellesley Central Hospital and Humber River Regional Hospital, University of Toronto, Ontario, Canada
Correspondence and offprint requests to: Andreas Pierratos MD, FRCPC, 2221 Keele St. #315 North York, Ontario, Canada M6M 3Z5.
Background. ß2-Microglobulin (ß2m) is a major component of dialysis-related amyloidosis. The available therapeutic options do not permit normalization of the serum ß2m level. In a cross-over trial, we studied the kinetics of ß2m during two different dialytic techniques.
Methods. Ten stable, anuric end-stage renal disease patients were studied during two consecutive weeks of three conventional (CHD) and six nocturnal haemodialysis (NHD) sessions. CHD was performed for 4 h three times weekly using a polysulfone dialyser (F80, surface area of 1.8 m2) with a mean blood and dialysate flow rate of 401±91.6 and 514±10.9 ml/min, respectively. The NHD was done with a smaller dialyser (F40, surface area of 0.7 m2) and lower blood (281±17 ml/min) and dialysate flow rates (99±1.2 ml/min) for 8 h, six nights a week.
Results. Weekly removal of urea (51.6±24.6 vs 43.1±20.5 g) and creatinine (8501±5204 vs 6319±4134 mg) were comparable with the two modalities of dialysis but the mass of ß2m removed was significantly higher with NHD (127±48 vs 585±309 mg, P<0.001), with a percentage reduction in serum level of 20.5±5.8 vs 38.8±7.1% (P<0.0001) and a Kt/Vß2m of 0.21±0.09 vs 0.56±0.17 (P<0.0006). The mean post-dialysis ß2m (20.8±6.3 vs 14.0±3.8 mg/dl, P=0.02), Tacß2m (26.2±5.2 vs 19.8±3.8 mg/dl, P=0.02) and pre-dialysis ß2m (ß2mpre) at the end of 1 week of therapy (24.4±7.6 vs 19.0±3.4 mg/dl, P=0.02) were lower with NHD. Long-term follow-up data were available in 13 and seven patients at the end of 1 and 2 years, respectively. Serum ß2mpre levels progressively declined from 27.2±11.7 mg/dl at initiation of NHD to 13.7±4.4 mg/dl by 9 months, and they remained stable thereafter.
Conclusions. NHD provides a much higher clearance of ß2m than CHD, leading to a long-term decrease in the pre-dialysis concentration of ß2m.
Keywords: dialysis; home dialysis; ß2-microglobulin; nocturnal haemodialysis
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  G. Bayliss and J. Danziger Nocturnal versus conventional haemodialysis: some current issues Nephrol. Dial. Transplant., September 19, 2009; (2009) gfp491v1. [Full Text] [PDF]
|
|
|
|
|
|
C. T. Chan, F. Lovren, Y. Pan, and S. Verma Nocturnal haemodialysis is associated with improved vascular smooth muscle cell biology Nephrol. Dial. Transplant., September 17, 2009; (2009) gfp495v1. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Eloot, W. van Biesen, A. Dhondt, R. de Smet, B. Marescau, P. P. De Deyn, P. Verdonck, and R. Vanholder Impact of increasing haemodialysis frequency versus haemodialysis duration on removal of urea and guanidino compounds: a kinetic analysis Nephrol. Dial. Transplant., July 1, 2009; 24(7): 2225 - 2232. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. C. van der Weerd, E. L. Penne, M. A. van den Dorpel, M. P.C. Grooteman, M. J. Nube, M. L. Bots, P. M. ter Wee, and P. J. Blankestijn Haemodiafiltration: promise for the future? Nephrol. Dial. Transplant., February 1, 2008; 23(2): 438 - 443. [Full Text] [PDF]
|
|
|
|
|
|
R. Vanholder, N. Meert, E. Schepers, G. Glorieux, A. Argiles, P. Brunet, G. Cohen, T. Drueke, H. Mischak, G. Spasovski, et al. Review on uraemic solutes II Variability in reported concentrations: causes and consequences Nephrol. Dial. Transplant., November 1, 2007; 22(11): 3115 - 3121. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. W. Meyer and T. H. Hostetter Uremia N. Engl. J. Med., September 27, 2007; 357(13): 1316 - 1325. [Full Text] [PDF]
|
|
|
|
|
|
M. S. MacGregor, J. W. M. Agar, and C. R. Blagg Home haemodialysis--international trends and variation Nephrol. Dial. Transplant., July 1, 2006; 21(7): 1934 - 1945. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Boure and R. Vanholder Which dialyser membrane to choose? Nephrol. Dial. Transplant., February 1, 2004; 19(2): 293 - 296. [Full Text] [PDF]
|
|
|
|
|
|
M. P. Kooistra Frequent prolonged home haemodialysis: three old concepts, one modern solution Nephrol. Dial. Transplant., January 1, 2003; 18(1): 16 - 18. [Full Text] [PDF]
|
|
|
|
|
|
P. J. Hanly and A. Pierratos Improvement of Sleep Apnea in Patients with Chronic Renal Failure Who Undergo Nocturnal Hemodialysis N. Engl. J. Med., January 11, 2001; 344(2): 102 - 107. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. A. WARD, B. SCHMIDT, J. HULLIN, G. F. HILLEBRAND, and W. SAMTLEBEN A Comparison of On-Line Hemodiafiltration and High-Flux Hemodialysis: A Prospective Clinical Study J. Am. Soc. Nephrol., December 1, 2000; 11(12): 2344 - 2350. [Abstract] [Full Text]
|
|