Since the identification ofβ2-microglobulin as a major component of‘dialysis amyloid’, concern about its removal by different dialysis methods has been raised. Haemodialysis with regenerated cellulose membranes increases serumβ2-microglobulin by 10–15. Serial measurements show a very early increase during cuprophan haemodialysis, the mechanism of which is as yet unknown. After cuprophan haemodialysis, serum values return to the initial pretreatment concentrations by the time of the next haemodialysis. In contrast to regenerated cellulose, dialysis with polycarbonate lowers serumβ2-microglobulin by 8, and dialysis with polysulphone by 53. As opposed to cuprophan, after polysulphone haemodialysis the serum concentrations have not returned to the initial pretreatment levels within 48 h. Comparison ofβ2-microglobulin removal using the same polysulphone membrane for haemodialysis and haemofiltration shows thatβ2-microglobulin is more effectively removed by convection than by diffusion when both treatment modes are matched for blood flow and urea clearance.Therefore, in contrast to haemodialysis with regenerated cellulose membranes, where a transient, intradialytic release ofβ2-microglobulin is induced, significant removal is observed using, higher permeable membranes. These findings may have implications for the generation of‘dial
展开▼
