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β 2 ‐Microglobulin and Low‐Flux SyntheticDialyzers
Author(s) -
Klinkmann Horst,
Buscaroli Andrea,
Stefoni Sergio
Publication year - 1998
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1046/j.1525-1594.1998.05082.x
Subject(s) - hemoconcentration , membrane , beta 2 microglobulin , dialysis , chemistry , ultrafiltration (renal) , polysulfone , dialysis tubing , chromatography , flux (metallurgy) , cellulose , polycarbonate , surgery , medicine , biochemistry , hematocrit , organic chemistry
The aim of this study was to compare the effect on β 2 ‐microglobulin (β 2 ‐M) plasma levels of dialyzers with 3 low‐flux synthetic membranes and regenerated cellulose (Cuprophan) in 12 chronic dialysis patients. The synthetic membrane materials chosen were low‐flux polymethylmethacrylate (PMMA), low‐flux polysulfone (PS 400), and polycarbonate‐polyether (Gambrane). Adequate and comparable removal of small solutes was provided by dialyzers with all 4 membrane materials used under similar conditions. A significant reduction of β 2 ‐M plasma levels was seen only with Gambrane while the other 2 synthetic membrane materials gave rise to increases similar to those known to occur with Cuprophan. After correction for the hemoconcentration caused by ultrafiltration, dialysis with Gambrane showed a 24% lower plasma β 2 ‐M level while the β 2 ‐M concentrations with the other 3 membrane materials were practically unchanged. In addition, the efficiency of Gambrane dialyzers in β 2 ‐M removal was able to significantly lower the predialysis plasma β 2 ‐M levels after only 5 dialysis sessions. The hemocompatibility of the 3 synthetic low‐flux membranes as judged by the white blood cell (WBC) count and complement activation was similar and therefore cannot be used to explain the different β 2 ‐M plasma levels. In anticipation of gaining further insight into the mechanisms of accumulation and deposition of β 2 ‐M in dialysis patients, a worthwhile approach may be to use a low‐flux membrane such as Gambrane which combines removal with protection against potential activating factors in the dialysis fluid.