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Medline ® Abstract for Reference 37

of 'Dialysis-related amyloidosis'

Relative importance of residual renal function and convection in determining beta-2-microglobulin levels in high-flux haemodialysis and on-line haemodiafiltration.
Fry AC, Singh DK, Chandna SM, Farrington K
Blood Purif. 2007;25(3):295. Epub 2007 Jul 2.
BACKGROUND: Convective blood purification improves beta(2)-microglobulin (beta(2)M) removal and may delay the onset of dialysis-related amyloidosis. We assessed the differential effects of high-flux haemodialysis (HD) and on-line haemodiafiltration (HDF) on plasma beta(2)M levels, given the enhanced convective capability of HDF.
METHODS: We measured pre-dialysis beta(2)M levels in 297 patients in a programme employing both high-flux HD and HDF, then analysed the relationship of beta(2)M to modality and other variables.
RESULTS: Independent determinants of plasma beta(2)M levels were residual renal function, age, HD vintage, and C-reactive protein load, but not the patient's predominant modality (high-flux HD or HDF). Patients with KRU levels<0.5 ml/min had significantly higher beta(2)M levels than patients with KRU between 0.5 and 1 ml/min.
CONCLUSIONS: Residual renal function is of overriding importance as a determinant of beta(2)M levels in HDpatients and may supersede enhanced convective clearance by HDF. Beneficial effects extend to very low levels of residual renal function.
Renal Unit, Lister Hospital, Stevenage, UK. andyfry@doctors.org.uk