Author/Editor		Urbančič, Alenka
Title		Elimination of beta-2-microglobulin with dialysis procedures
Type		članek
Source		In: Buturović-Ponikvar J, Bren AF, editors. Zbornik 2. slovenski nefrološki kongres z mednarodno udeležbo ob 30. letnici dialize in transplantacije ledvic v Sloveniji; 2000 sep 27-30; Brdo pri Kranju. Ljubljana: Klinični center, Klinični oddelek za nefrologijo,
Publication year		2000
Volume		str. 165-70
Language		eng
Abstract		Beta-2-microglobulin (B2M) is the main constituent of the amyloid in dialysis related amyloidosis. A lot of research work was dedicated to find the effective way for the removal of this low molecular weight protein. High plasma concentration of B2M in chronic dialysis (CHD) patients is a result of residual renal function, extrarenal endogenous clearance and dialytic clearance. Diffusion as a transport mechanism affects B2M removal during hemodialysis and biofiltration. Convective flux of B2M depends on ultrafiltration rate. Chemical structure of the membrane is the base for continuous interactions with plasma proteins during dialysis precedures. The permeability properties of the membrane for plasma proteins, solubility, concentration and polarisation of plasma proteins as well as pH, temperature, blood flow, dialysate flow, viscosity further modify functional properties of the membrane. Continuous interaction between blood constituents and membrane and between diffusion and convection during dialytic procedures play a game in B2M removal processes. In our clinical studies during biofiltration with AN69 195 to 330 mg of B2M was removed per session, using AN69 dialyser membrane. Both adsorption and filtration with dynamic changes in first minutes and steady state pattern after an hour were observed. In that stable phase time was the factor of efficacy in B2M removal. A mass of B2M removed (= a daily B2M produced), is important in delaying the onset of B2M amyloidosis.
Descriptors		BETA 2-MICROGLOBULIN HEMODIALYSIS AMYLOIDOSIS