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Kinetics of 131 I‐β 2 Microglobulin in Hemodialysis Patients: Assessment Using Total Body Counting
Author(s) -
Chanard Jacques,
Caudwell Valérie,
Valeire Jacques,
Vincent Claude,
Randoux Christine,
Wuillai Anne,
Wynckel Alain
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.1525-1594.1998.06197.x
Subject(s) - polysulfone , hemodialysis , membrane , chemistry , chromatography , dialysis , dialysis tubing , hemofiltration , beta 2 microglobulin , adsorption , polyacrylonitrile , surgery , medicine , biochemistry , organic chemistry , polymer
The kinetics of 131 I‐β 2 ‐microglobulin (β 2 ‐M) were studied using external total body gamma counting in a low noise chamber after administration of trace doses of radioactivity (4 μCi) in 14 uremic patients treated by either hemodialysis or hemofiltration. Data were collected over a 1 week period that included 3 dialysis sessions. The following artificial membranes were used: Cuprophan, polyacrylonitrile AN69, polysulfone, polymethylmethacrylate (PMMA), and polyamide. Radiolabeled β 2 ‐M excretion by an extrarenal route was nearly nonexistent. The 131 I‐β 2 ‐M half‐life was between 2.4 and 8 days, shorter in patients with residual diuresis. A mean removal of 153 ± 33 mg/L of β 2 ‐M was obtained per dialysis session with a highly permeable membrane. A hemofiltration session (25 L exchange per session) was slightly more efficient in removing β 2 ‐M than a 4 h hemodialysis session with the same AN69 highly permeable membrane. The amounts of 131 I‐β 2 ‐M binding on the membranes, expressed as β 2 ‐M equivalents, were 0, 16, 54, 58, and 59 mg/m 2 for Cuprophan, polysulfone, polyacrylonitrile AN69, polyamide, and PMMA, respectively. In conclusion, the decrease of total body gamma counting directly reflected the β 2 ‐M breakdown and removal in hemodialysis patients. Intact β 2 ‐M was removed by convection with synthetic, highly permeable membranes. In addition, membrane adsorption accounted for 15% (polysulfone) to near 100% (PMMA) of the β 2 ‐M removal per session. Adsorption was of the same magnitude regardless of the dialysis technique in use, indicating a membrane saturability process. None of the currently available dialysis procedures based on a 3 sessions per week schedule can balance β 2 ‐M generation.