Beta-2-Microglobulin Handling in Dialysis

Klinke, B.; Röckel, A; Perschel, W. Th.; Abdelhamid, S.; Fiegel, P.; Walb, Dieter

doi:10.1159/000417483

Cited by 8 publications

(5 citation statements)

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“…We measured vancomycin removal by a cellulose triacetate dialyzer anisms mediating the removal of low molecular weight proteins. A number of studies published in the past 15 (1.9 m 2 ; K UF , 36 ml/hr/mm Hg) in eight patients who received 1 g of vancomycin intravenously during the last years [11, [52][53][54][55][56][57][58][59][60][61][62][63] support several general conclusions. First, ␤ 2 m removal by low-flux unsubstituted cellulosic hour of dialysis.…”

Section: Basic Characteristics Of Polyethersulfone) a Hydrophilic Additive [Polyvinylpyrrolidone (Pvp)] Acts As A Polymer Alloy Pvp Is Usmentioning

confidence: 83%

Effect of membrane composition and structure on solute removal and biocompatibility in hemodialysis

Clark

Hamburger

Lysaght

1999

Kidney International

177

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Effect of membrane composition and structure on solute removal and biocompatibility in hemodialysis. Significant changes in extracorporeal membranes have occurred over the past five decades in which hemodialysis (HD) has been available as a therapy for both acute renal failure (ARF) and end-stage renal disease (ESRD). For cellulosic membranes, these changes have included a reduction in thickness, hydroxyl group substitution, and an increase in pore size. These modifications have resulted in enhanced efficiency of small solute removal, a broader spectrum of overall solute removal, and an attenuation of complement activation in comparison to the thick, unsubstituted cellulosic membranes of low permeability used in the early days of HD therapy. Synthetic membranes, originally developed specifically for use in high-flux HD and hemofiltration, have also evolved during this same time period. In fact, the initially clear distinction between low-flux regenerated cellulosic and high-flux synthetic membranes has become blurred, as membrane formulators have developed products designed to appeal to enthusiasts for both membrane formats. The purpose of this review is to characterize both the solute removal and biocompatibility characteristics of dialysis membranes according to their composition (that is, polymeric makeup) and structure. In this regard, the manner in which membrane biocompatibility interacts with flux is highlighted.

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Section: Basic Characteristics Of Polyethersulfone) a Hydrophilic Additive [Polyvinylpyrrolidone (Pvp)] Acts As A Polymer Alloy Pvp Is Usmentioning

confidence: 83%

Effect of membrane composition and structure on solute removal and biocompatibility in hemodialysis

Clark

Hamburger

Lysaght

1999

Kidney International

177

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“…Blood contact with membrane surfaces during hemodialysis causes deposition of dif ferent blood substances, like peptides, pro teins and fibrin [10,11], This secondary membrane formation reduces ultrafiltration rate and permeability, especially of sub stances with a MW of more than 5 kD; ad sorption of substances with a smaller MW seems to play a minor role [5][6][7], In this study we compared two synthetic membranes, the polyamide and the polysul fone, with two suprammonium-rayon mem branes, regarding their convective permeabil ity characteristics in the MW range of 10-90 kD. Instead of different-sized dextrans [12,13], we used endogenous proteins with a de fined MW as marker substances.…”

Section: Discussionmentioning

confidence: 99%

“…The hypothesis of uremic toxins in the higher MW range might be clarified by the use of more permeable membranes. Searching for such a membrane, we previously studied polysulfone, cellulose-triacetate and cuprammonium-rayon hemofilters [5][6][7]. Under in vitro conditions, these membranes were reported to be permeable like the glomerulus; but, in vivo, after secondary membrane formation, they are impermeable for substances with a MW >20 kD [8,9], In this study we compared the polyamide (Polyflux 160, Gambro) and cuprammoniumrayon dialyzers (AM-FP-17, Asahi; Clirans SEI5NL, Terumo) with the polysulfone dialyzer (F60, Fresenius).…”

Section: Introductionmentioning

confidence: 99%

Dialyzer Permeability for Low-Molecular-Weight Proteins

et al. 1994

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The aim of the study was to compare under in vivo conditions the new polyamide (Polyflux 160, Gambro) and cuprammonium-rayon dialyzers (AM-FP-17, Asahi; Clirans SE15NL, Terumo) with the polysulfone dialyzer (F60, Fresenius) regarding their permeability for beta-2-microglobulin (11.8 kD), retinol binding protein (21 kD), alpha-1-microglobulin (26.7 kD), alpha-1-glycoprotein (41 kD), alpha-1-antitrypsin (54 kD), albumin (66.3 kD) and transferrin (90 kD). The marker substances were measured by nephelometry or radioimmunoassay. To evaluate the membrane permeability, sieving coefficients 20 min after the start of hemodialysis were calculated using the concentration in the afferent and efferent blood line and in the ultrafiltrate. To get an idea about convective protein loss during a hemofiltration session, the values were computed in milligrams per 20 liters ultrafiltrate. Concerning the permeability of beta-2-microglobulin, the F60, AM-FP-17 and the Polyflux 160 hemofilter were comparable. In the molecular weight range of 20-60 kD both synthetic hemofilters were nearly impermeable. However, the cuprammonium-rayon dialyzers showed in this range a higher cutoff. The calculated albumin and transferrin loss is lower than those of CAPD patients or patients with nephrotic syndrome.

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“…Several studies have demonstrated the adsorption of P2M onto synthetic dialyzer membranes . The polyacrylonitrile (PAN-AN69) (AN69) membrane is one of those with a marked adsorption capacity for P2M (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). Unfortunately, none of these adsorption studies has provided data about the influence of blood flow on the amount of P2M being adsorbed onto membranes.…”

Section: Methodsmentioning

confidence: 99%

Influence of Blood Flow on Adsorption of β₂‐Microglobulin onto AN69 Membrane

1997

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Adsorption onto the dialyzer membrane is a contributing factor to the elimination of P,-microglobulin (P,M) from the sera of uremic patients. The purpose of this prospective study was to ascertain the influence of the blood flow rate on adsorption of P2M onto the polyacrylonitrile (AN69) hollow-fiber dialyzer membrane in 8 patients during regular hemodialysis (HD). Blood first passed through a low-flux polysulfone dialyzer and then through an AN69 dialyzer, which was not in contact with the dialysis fluid. During the investigation period (first hour of the HD session), the blood flow rate was 100 mli min (first part of the study), 200 mumin (second part of the study), and 300 ml/min (third part of the study). Ultrafiltration was not performed during the investigation period. At the start of the HD sessions, the serum concentration of P,M in the afferent blood line did not differ significantly among the 3 parts of the study. Serum P,M was measured in samples taken from the afferent and efferent blood lines of the AN69 dialyzer at 5, 10, 15, 30, 45, and 60 min. The serum P2M concentration decreased significantly in blood that had passed through the AN69 dialyzer. This decrease, indicating membrane adsorption, was maximal during the first part and minimal during the third part of study. The decrease in the contact time between the blood and the AN69 could be the underlying cause. The calculated quantities of P2M adsorbed onto the AN69 membrane (44.2 * 10.2,43.2 12.1, and 42.6 17.3 mg) did not differ significantly among the 3 parts of the study. These results suggest that an increase in blood flow rate from 100 to 300 mllmin did not significantly affect the quantity of P,M adsorbed onto the AN69 membrane.

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Beta-2-Microglobulin Handling in Dialysis

Cited by 8 publications

References 0 publications

Effect of membrane composition and structure on solute removal and biocompatibility in hemodialysis

Effect of membrane composition and structure on solute removal and biocompatibility in hemodialysis

Dialyzer Permeability for Low-Molecular-Weight Proteins

Influence of Blood Flow on Adsorption of β₂‐Microglobulin onto AN69 Membrane

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Beta-2-Microglobulin Handling in Dialysis

Cited by 8 publications

References 0 publications

Effect of membrane composition and structure on solute removal and biocompatibility in hemodialysis

Effect of membrane composition and structure on solute removal and biocompatibility in hemodialysis

Dialyzer Permeability for Low-Molecular-Weight Proteins

Influence of Blood Flow on Adsorption of β2‐Microglobulin onto AN69 Membrane

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Influence of Blood Flow on Adsorption of β₂‐Microglobulin onto AN69 Membrane