Fitness of Biocompatible High-Flux Hemodiafiltration for Dialysis-Related Amyloidosis

Aims: In order to assess the long-term influence of high-flux hemodiafiltration (HDF) on hemodynamic stability in patients with dialysis-related amyloidosis. Methods: HDF with high-flux dialyzers was performed for a year in 11 patients who had undergone the surgery for carpal tunnel syndrome. Patients were divided into two groups, and for each group synthetic or cellulose membrane dialyzers were applied. Results: A year after the exchange from standard hemodialysis to HDF with cellulose high-flux dialyzers, β2-microglobulin was decreased (45 ± 3 to 28 ± 2 mg/l, n = 5, p < 0.05), but plasma non-refilling ratio was not altered. However, the continuance of synthetic high-flux HDF for a year decreased plasma non-refilling ratio (17 ± 5 to 7 ± 4%, p < 0.05), hypotensive episodes (4.3 ± 0.6 to 2.5 ± 0.4 sessions/month, p < 0.05) and muscle cramps (3.8 ± 0.5 to 1.8 ± 0.5 sessions/month, p < 0.01) in addition to the decrements in serum β2-microglobulin (45 ± 5 to 33 ± 2 mg/l, n = 6, p < 0.01). Conclusions: Although the study on a large number of patients may be required to draw a final conclusion, our present data suggest that biocompatible high-flux HDF is uniquely suited for dialysis-related amyloidosis.

[1]  Y. Wada,et al.  Implication of an increased oxidative stress in the formation of advanced glycation end products in patients with end-stage renal failure. , 1997, Kidney international.

[2]  B. Kirschbaum.  The decline in serum albumin after conversion to high flux, high efficiency dialysis. , 1994, Artificial organs.

[3]  L. Gesualdo,et al.  C5b-9 generation and cytokine production in hemodialyzed patients. , 1993, Kidney international. Supplement.

[4]  H. Suzuki,et al.  High-performance hemodiafiltration and blood pressure stability. , 1997, Nephron.

[5]  À. Argilés,et al.  Renal transplantation relieves the symptoms but does not reverse beta 2-microglobulin amyloidosis. , 1996, Journal of the American Society of Nephrology : JASN.

[6]  T. Bardin,et al.  Dialysis related amyloidosis. , 1987, The Journal of rheumatology.

[7]  D. Goldsmith,et al.  Interdialysis blood pressure control by long haemodialysis sessions. , 1996, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[8]  R. Ulan,et al.  Plasma volume changes induced by hypertonic hemodiafiltration and standard hemodialysis. , 1987, American journal of nephrology.

[9]  J. Chanard,et al.  Kinetics of 125I-β2-microglobulin turnover in dialyzed patients , 1992 .

[10]  F. Gejyo,et al.  Serum levels of beta 2-microglobulin as a new form of amyloid protein in patients undergoing long-term hemodialysis. , 1986, The New England journal of medicine.

[11]  P. Kerr,et al.  Haemodiafiltration in high-cardiovascular-risk patients. , 1992, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[12]  E. Movilli,et al.  A prospective comparison of bicarbonate dialysis, hemodiafiltration, and acetate-free biofiltration in the elderly. , 1996, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[13]  G. Medici,et al.  Conjugated diene fatty acids in patients with chronic renal failure: evidence of increased lipid peroxidation? , 1993, Nephron.

[14]  C. Ronco,et al.  Technical and clinical evaluation of different short, highly efficient dialysis techniques. , 1988, Contributions to nephrology.

[15]  L. Henderson,et al.  Hemodialysis Hypotension: The Interleukin Hypothesis , 1983 .

[16]  A. Plückthun,et al.  Production of recombinant human beta2-microglobulin for scintigraphic diagnosis of amyloidosis in uremia and hemodialysis. , 2000, European journal of biochemistry.