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β2-Microglobulin kinetics in nocturnal haemodialysis
Background.β2-Microglobulin (β2m) is a major component of dialysis-related amyloidosis. The available therapeutic options do not permit normalization of the serum β2m level. In a cross-over trial, we studied the kinetics of β2m during two different dialytic techniques. Methods. Ten stable, anuric en...
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| Published in: | Nephrology, dialysis, transplantation dialysis, transplantation, 2000-01, Vol.15 (1), p.58-64 |
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| container_title | Nephrology, dialysis, transplantation |
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| creator | Raj, Dominic S. C. Ouwendyk, Michaelene Francoeur, Robert Pierratos, Andreas |
| description | Background.β2-Microglobulin (β2m) is a major component of dialysis-related amyloidosis. The available therapeutic options do not permit normalization of the serum β2m level. In a cross-over trial, we studied the kinetics of β2m 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 β2m removed was significantly higher with NHD (127±48 vs 585±309 mg, P |
| doi_str_mv | 10.1093/ndt/15.1.58 |
| format | article |
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C. ; Ouwendyk, Michaelene ; Francoeur, Robert ; Pierratos, Andreas</creator><creatorcontrib>Raj, Dominic S. C. ; Ouwendyk, Michaelene ; Francoeur, Robert ; Pierratos, Andreas</creatorcontrib><description>Background.β2-Microglobulin (β2m) is a major component of dialysis-related amyloidosis. The available therapeutic options do not permit normalization of the serum β2m level. In a cross-over trial, we studied the kinetics of β2m 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 β2m 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/Vβ2m of 0.21±0.09 vs 0.56±0.17 (P<0.0006). The mean post-dialysis β2m (20.8±6.3 vs 14.0±3.8 mg/dl, P=0.02), Tacβ2m (26.2±5.2 vs 19.8±3.8 mg/dl, P=0.02) and pre-dialysis β2m (β2mpre) 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 β2mpre 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 β2m than CHD, leading to a long-term decrease in the pre-dialysis concentration of β2m.</description><identifier>ISSN: 0931-0509</identifier><identifier>EISSN: 1460-2385</identifier><identifier>DOI: 10.1093/ndt/15.1.58</identifier><identifier>CODEN: NDTREA</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; dialysis ; Emergency and intensive care: renal failure. Dialysis management ; home dialysis ; Intensive care medicine ; Medical sciences ; nocturnal haemodialysis ; β2-microglobulin</subject><ispartof>Nephrology, dialysis, transplantation, 2000-01, Vol.15 (1), p.58-64</ispartof><rights>2000 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,4024,27923,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1269624$$DView record in Pascal Francis$$Hfree_for_read</backlink></links><search><creatorcontrib>Raj, Dominic S. C.</creatorcontrib><creatorcontrib>Ouwendyk, Michaelene</creatorcontrib><creatorcontrib>Francoeur, Robert</creatorcontrib><creatorcontrib>Pierratos, Andreas</creatorcontrib><title>β2-Microglobulin kinetics in nocturnal haemodialysis</title><title>Nephrology, dialysis, transplantation</title><addtitle>Nephrol. Dial. Transplant</addtitle><description>Background.β2-Microglobulin (β2m) is a major component of dialysis-related amyloidosis. The available therapeutic options do not permit normalization of the serum β2m level. In a cross-over trial, we studied the kinetics of β2m 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 β2m 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/Vβ2m of 0.21±0.09 vs 0.56±0.17 (P<0.0006). The mean post-dialysis β2m (20.8±6.3 vs 14.0±3.8 mg/dl, P=0.02), Tacβ2m (26.2±5.2 vs 19.8±3.8 mg/dl, P=0.02) and pre-dialysis β2m (β2mpre) 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 β2mpre 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 β2m than CHD, leading to a long-term decrease in the pre-dialysis concentration of β2m.</description><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>dialysis</subject><subject>Emergency and intensive care: renal failure. Dialysis management</subject><subject>home dialysis</subject><subject>Intensive care medicine</subject><subject>Medical sciences</subject><subject>nocturnal haemodialysis</subject><subject>β2-microglobulin</subject><issn>0931-0509</issn><issn>1460-2385</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><recordid>eNo9jE1OwzAYRC0EEqGw4gJZsHX6-d9eogooUgsboIhN5NgOmKZJFacSvRYH4UxEKmIzM9J7GoQuCRQEDJu2fpgSUZBC6COUES4BU6bFMcpGSjAIMKfoLKVPADBUqQyJn2-Kl9H13XvTVbsmtvk6tmGILuXjbjs37PrWNvmHDZvOR9vsU0zn6KS2TQoXfz1Bz7c3T7M5Xjze3c-uFzgSJgZsvQMrOKuqSlW6DrUXoZaGanCM6sAMaK2lGxOM9F45D9JIbqxTVfDcswm6OvxubXK2qXvbupjKbR83tt-XhI465aOGD1pMQ_j6x7Zfl1IxJcr561v5slrxh6UyJWe_JPhYWQ</recordid><startdate>200001</startdate><enddate>200001</enddate><creator>Raj, Dominic S. C.</creator><creator>Ouwendyk, Michaelene</creator><creator>Francoeur, Robert</creator><creator>Pierratos, Andreas</creator><general>Oxford University Press</general><scope>BSCLL</scope><scope>IQODW</scope></search><sort><creationdate>200001</creationdate><title>β2-Microglobulin kinetics in nocturnal haemodialysis</title><author>Raj, Dominic S. C. ; Ouwendyk, Michaelene ; Francoeur, Robert ; Pierratos, Andreas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-i135t-adc0a543bbb7b8fefd5ef69280c328e3908886c088096dd7cd069649ac7bed4d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>dialysis</topic><topic>Emergency and intensive care: renal failure. Dialysis management</topic><topic>home dialysis</topic><topic>Intensive care medicine</topic><topic>Medical sciences</topic><topic>nocturnal haemodialysis</topic><topic>β2-microglobulin</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Raj, Dominic S. C.</creatorcontrib><creatorcontrib>Ouwendyk, Michaelene</creatorcontrib><creatorcontrib>Francoeur, Robert</creatorcontrib><creatorcontrib>Pierratos, Andreas</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><jtitle>Nephrology, dialysis, transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Raj, Dominic S. C.</au><au>Ouwendyk, Michaelene</au><au>Francoeur, Robert</au><au>Pierratos, Andreas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>β2-Microglobulin kinetics in nocturnal haemodialysis</atitle><jtitle>Nephrology, dialysis, transplantation</jtitle><addtitle>Nephrol. Dial. Transplant</addtitle><date>2000-01</date><risdate>2000</risdate><volume>15</volume><issue>1</issue><spage>58</spage><epage>64</epage><pages>58-64</pages><issn>0931-0509</issn><eissn>1460-2385</eissn><coden>NDTREA</coden><abstract>Background.β2-Microglobulin (β2m) is a major component of dialysis-related amyloidosis. The available therapeutic options do not permit normalization of the serum β2m level. In a cross-over trial, we studied the kinetics of β2m 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 β2m 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/Vβ2m of 0.21±0.09 vs 0.56±0.17 (P<0.0006). The mean post-dialysis β2m (20.8±6.3 vs 14.0±3.8 mg/dl, P=0.02), Tacβ2m (26.2±5.2 vs 19.8±3.8 mg/dl, P=0.02) and pre-dialysis β2m (β2mpre) 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 β2mpre 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 β2m than CHD, leading to a long-term decrease in the pre-dialysis concentration of β2m.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><doi>10.1093/ndt/15.1.58</doi><tpages>7</tpages></addata></record> |
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| subjects | Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences dialysis Emergency and intensive care: renal failure. Dialysis management home dialysis Intensive care medicine Medical sciences nocturnal haemodialysis β2-microglobulin |
| title | β2-Microglobulin kinetics in nocturnal haemodialysis |
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