Reduction of Free Immunoglobulin Light Chains Using Adsorption Properties of Hemodiafiltration with Endogenous Reinfusion

In this work we investigated the acute effects of hemodiafiltration with endogenous reinfusion (HFR therapy) on the removal of free immunoglobulin light chains (FIgLCs), which may be considered members of the family of uremic toxins. In two groups of patients – group 1 (polyclonal FIgLCs production) and group 2 (monoclonal plasma cell proliferative disorders), we analyzed the pre- and postdialysis levels of ĸ- and λ-chains. In group 1 we observed a significant reduction of FIgLCs (p < 0.01). A similar trend was found in patients of group 2 only for ĸ-chains. The FIgLCs removal ratio was significantly higher for ĸ- than λ-chains in the two patient groups. In vitro data showed affinity of macroporous resin to binding FIgLCs. Our results show that the HFR therapy could be effective in removing FIgLCs, particularly ĸ-chains in dialysis patients with polyclonal and monoclonal FIgLCs production.

[1]  A. Piccoli,et al.  Effect of haemodiafiltration with online regeneration of ultrafiltrate on oxidative stress in dialysis patients. , 2007, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[2]  Neil D Evans,et al.  Efficient removal of immunoglobulin free light chains by hemodialysis for multiple myeloma: in vitro and in vivo studies. , 2006, Journal of the American Society of Nephrology : JASN.

[3]  P. Ghezzi,et al.  Hemodiafiltration with endogenous reinfusion. , 2007, Contributions to nephrology.

[4]  A. Testa,et al.  In vivo Removal of High- and Low-Molecular-Weight Compounds in Hemodiafiltration with On-Line Regeneration of Ultrafiltrate , 2006, Nephron Clinical Practice.

[5]  C. Consani,et al.  Effects on inflammatory and nutritional markers of haemodiafiltration with online regeneration of ultrafiltrate (HFR) vs online haemodiafiltration: a cross-over randomized multicentre trial. , 2006, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[6]  G. Cohen.  Immunoglobulin light chains in uremia. , 2003, Kidney international. Supplement.

[7]  Raymond Vanholder,et al.  Review on uremic toxins: classification, concentration, and interindividual variability. , 2003, Kidney international.

[8]  M. Rudnicki,et al.  Effect of dialysis on serum/plasma levels of free immunoglobulin light chains in end-stage renal disease patients. , 2002, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.