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PROGRESS IN UREMIC TOXIN RESEARCH: Beta2‐Microglobulin
Author(s) -
Drüeke Tilman B.,
Massy Ziad A.
Publication year - 2009
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/j.1525-139x.2009.00584.x
Subject(s) - beta 2 microglobulin , medicine , amyloidosis , hemodialysis , dialysis , amyloid (mycology) , kidney disease , complication , pathophysiology , uremic toxins , disease , toxin , gastroenterology , endocrinology , pathology , biochemistry , chemistry
Among the uremic toxins in the “middle molecule” range, beta2‐microglobulin (β2‐M) is certainly one of the most frequently studied compounds. Its serum level increases with the progression of chronic kidney disease, to reach very high concentrations in patients with end‐stage kidney disease. It is the major protein component of dialysis‐related amyloidosis, a dramatic complication which results from high extracellular concentration and posttranslational modification of β2‐M and a number of other promoters of amyloid fibril formation and deposition in osteo‐articular tissues. Effective removal of β2‐M can be achieved with highly effective hemodialysis and hemodiafiltration techniques but predialysis session serum levels cannot be normalized. The prevalence and severity of β2‐M amyloidosis appear to have decreased in the last 20 years, although its occurrence may simply be delayed.