Comparison of myoglobin clearance in three types of blood purification modalities.

INTRODUCTION Myoglobin, which can cause acute kidney injury has a relatively high molecular weight and is poorly cleared by diffusion. We compared and examined myoglobin clearance by changing the blood purification membrane and modality in patients with a myoglobin blood concentration ≥ 1,000 ng/mL. METHODS We retrospectively analyzed three patient groups based on the following three types of continuous hemofiltration: AN69ST membrane, polymethylmethacrylate membrane, and high-flow hemodiafiltration with increased dialysate flow rate using the polymethylmethacrylate membrane. RESULTS There was no significant difference in clearance in continuous hemofiltration between AN69ST and polymethylmethacrylate membranes. However, the high-flow hemodiafiltration group showed the highest myoglobin clearance (p = 0.003). In the polymethylmethacrylate membrane, changing the treatment modality to high-flow hemodiafiltration increased clearance above the theoretical value, possibly due to internal filtration. CONCLUSION To remove myoglobin by kidney replacement therapy from patients with hypermyoglobinemia, a modality such as high-flow hemodiafiltration would be desirable. This article is protected by copyright. All rights reserved.