Removal of Beta 2-Microglobulin by Hemodialysis and Hemofiltration: a Four Year Follow Up

Efficient removal of total body burden beta 2-Micro-globulin (beta 2-M) in uremia is a continuing challenge, as dialysis-related amyloidosis represents a major complication of chronic renal replacement therapy. To investigate long-term beta 2-M removal we studied 3 groups of stable end-staged renal failure patients over a period of 4 years; we compared low flux (cuprophane) hemodialysis (n=12), high flux (polysulfone) hemodialysis (n=12) and hemofiltration using high flux polysulfone (n=8). In contrast to the cuprophane membrane, the polysulfone membrane eliminated considerable amounts of beta 2-M. This was associated with a sustained reduction of predialysis serum beta 2-M-levels (by 20 %). Compared with high flux hemodialysis, hemofiltration provided a 50 % higher elimination of beta 2-M. Thus, our long-term evaluation of beta 2-M removal suggests that hemofiltration rather than hemodialysis may be the treatment of choice for delaying the incidence of dialysis-related amyloidosis.