Serum Beta-2-Microglobulin Level and Residual Renal Function in Peritoneal Dialysis

Several studies have shown that patients who have been dialyzed with high-flux biocompatible membranes have a lower plasma level of beta 2-microglobulin and a lower incidence of amyloid disease compared with patients who have been dialyzed with low-flux bioincompatible membranes. However, because high-flux membranes are associated with significant dialytic removal of beta 2-microglobulin, the specific role of membrane biocompatibility in influencing the rate of increase of beta 2-microglobulin has not been previously determined. This study investigated the effect of biocompatibility on the rate of increase of plasma levels of beta 2-microglobulin in 159 new hemodialysis patients from 13 dialysis centers (ten centers affiliated with Dallas Nephrology Associates and three with Vanderbilt University Medical Center) by using two low-flux membranes with widely different biocompatibilities. These patients were prospectively randomized to be dialyzed with either a low-flux biocompatible membrane or a low-flux bioincompatible membrane. Plasma beta 2-microglobulin levels were measured at 0, 3, 6, 9, 12, and 18 months. Sixty-six patients completed the 18-month study. Plasma beta 2-microglobulin increased in all patients; however, the increase was not significantly different from baseline at any time point in the group that used the biocompatible membrane. In this group, beta 2-microglobulin increased from (mean +/- SD) 27.8 +/- 14.8 mg/L to 34.0 +/- 10.0 mg/L at 18 months (P = not significant), and the mean increase at 18 months was 2.6 +/- 14.7 mg/L. In contrast, the increase in plasma beta 2-microglobulin level in the bioincompatible membrane group became significant in Month 6 when the levels had increased from a baseline of 24.8 +/- 9.6 mg/L to 29.5 +/- 12.2 mg/L (P < 0.001); these increases continued to be significant until Month 18, when serum beta 2-microglobulin reached 36.8 +/- 13.9 mg/L with an average increase of 11.8 +/- 11.2 mg/L (P < 0.0001). The higher rate of plasma B2-microglobulin increase in the group that had been dialyzed with the bioincompatible membrane was also evident when only patients who had completed the study were analyzed. There were no significant differences in the actual level of beta 2-microglobulin or in residual renal function between the two groups during the 18 months of the study. It was concluded that over a period of 18 months, the use of biocompatible membranes, even in the low-flux configuration, is associated with a significantly slower increase in plasma beta 2-microglobulin, independent of the influence of residual renal function.

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Relative Importance of Residual Renal Function and Convection in Determining Beta-2-Microglobulin Levels in High-Flux Haemodialysis and On-Line Haemodiafiltration

Blood Purification ◽

10.1159/000104870 ◽

2007 ◽

Vol 25 (3) ◽

pp. 295-302 ◽

Cited By ~ 46

Author(s):

Andrew C. Fry ◽

Dhruv K. Singh ◽

Shahid M. Chandna ◽

Ken Farrington

Keyword(s):

Renal Function ◽

Residual Renal Function ◽

High Flux ◽

Relative Importance ◽

On Line ◽

Beta 2 ◽

Beta 2 Microglobulin

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Incremental Hemodialysis Schedule in Patients with Higher Residual Renal Function at the Start of Dialysis

Advances in Nephrology ◽

10.1155/2014/236245 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 5

Author(s):

Milagros Fernández Lucas ◽

José Luis Teruel ◽

Gloria Ruíz-Roso ◽

Martha Díaz ◽

Viviana Raoch ◽

...

Keyword(s):

Renal Function ◽

Cost Effective ◽

Clinical Situation ◽

Residual Renal Function ◽

Additional Benefit ◽

Weekly Schedule ◽

Decline Rate ◽

Incremental Hemodialysis ◽

Beta 2 ◽

Beta 2 Microglobulin

We present an observational study to evaluate a progressive schedule of dose of dialysis, starting with 2 HD/week, when the renal clearance of urea was equal to or greater than 2,5 mL/min/1,73 m2 and the patient is in a stable clinical situation. From 2006 to 2011, 182 patients started hemodialysis in our center, of which 134 were included in the study. Residual renal function (RRF), Kt/V, eKru, nPCR, hemoglobin, weekly erythropoietin dose, and beta-2-microglobulin were determined at 6, 12, 18, 24, and 30 months after dialysis initiation. Seventy patients (52%) began with the progressive schedule of 2 HD/week and 64 (48%) patients began with the conventional thrice-weekly schedule (3 HD/week). The decline of RRF was lower in the group of 2 HD/week: 0,20 (0,02–0,53) versus 0,50 (0,14–1,08) mL/min/month (median and interquartile range, P=0,009). No relationship was found between the decline rate and the basal RRF. Survival analysis did not show differences between both groups. Our experience demonstrates that patients with higher residual renal function may require less than conventional 3 HD sessions per week at the start of dialysis. Twice-weekly hemodialysis schedule is safe and cost-effective and may have additional benefit in maintaining the residual renal function.

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The excess weight gain in peritoneal dialysis in the first year and its consequences on the loss of residual renal function.

10.26226/morressier.59a56f96d462b8028d895cb9 ◽

2017 ◽

Author(s):

Lilia Ben Lasfar

Keyword(s):

Renal Function ◽

Peritoneal Dialysis ◽

Weight Gain ◽

Residual Renal Function ◽

Excess Weight ◽

First Year ◽

Excess Weight Gain

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RESIDUAL RENAL FUNCTION IN PERITONEAL DIALYSIS PATIENTS

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2011.4.4 ◽

2011 ◽

pp. 30-34

Author(s):

Hoang Bui Bao Hoang ◽

Huu Loi Le ◽

Tam Vo ◽

Thi Anh Thu Tran

Keyword(s):

Renal Function ◽

Peritoneal Dialysis ◽

Close Correlation ◽

Residual Renal Function ◽

Central Hospital ◽

Dialysis Patients

Background: Peritoneal dialysis is used regularlly in treatment of ESRDs. Residual renal function (RRF) in these patients helps the adequacy of PD therapy very much. Objectives: 1. Study RRF of PD patients at Department of Nephro – Rheumatology, Hue Central Hospital. 2. Search the correlation between RRF and Kt/V. Patients and methods: 35 PD patients at Department of Nephro – Rheumatology, Hue Central Hospital. Measure RRF and Kt/V by formulars that depend on blood, urine and PD fluid samples. Results: Mean RRF of PD patients is 4.36 ± 13.8 ml/minute. There is a close correlation between RRF and Kt/V (r=0.79, p<0.01). Conclusion: RRF in PD patients correlates with Kt/V.

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Predictors of Faster Decline of Residual Renal Function in Taiwanese Peritoneal Dialysis Patients

Peritoneal Dialysis International ◽

10.1177/089686080802803s35 ◽

2008 ◽

Vol 28 (3_suppl) ◽

pp. 191-195 ◽

Cited By ~ 3

Author(s):

Chia-Te Liao ◽

Chih-Chung Shiao ◽

Jenq-Wen Huang ◽

Kuan-Yu Hung ◽

Hsueh-Fang Chuang ◽

...

Keyword(s):

Diabetes Mellitus ◽

Renal Function ◽

Peritoneal Dialysis ◽

Clinical Laboratory ◽

Statistical Significance ◽

Univariate Analysis ◽

Residual Renal Function ◽

Measure Data ◽

Chi Square ◽

Artery Disease

⋄ Objective Loss of residual renal function (RRF) in peritoneal dialysis (PD) patients is a powerful predictor of mortality. The present study was conducted to determine the predictors of faster decline of RRF in PD patients in Taiwan. ⋄ Methods The study enrolled 270 patients starting PD between January 1996 and December 2005 in a single hospital in Taiwan. We calculated RRF as the mean of the sum of 24-hour urea and creatinine clearance. The slope of the decline of residual glomerular filtration rate (GFR) was the main outcome measure. Data on demographic, clinical, laboratory, and treatment parameters; episodes of peritonitis; and hypotensive events were analyzed by Student t-test, Mann–Whitney U-test, and chi-square, as appropriate. All variables with statistical significance were included in a multivariate linear regression model to select the best predictors ( p < 0.05) for faster decline of residual GFR. ⋄ Results All patients commencing PD during the study period were followed for 39.4 ± 24.0 months (median: 35.5 months). The average annual rate of decline of residual GFR was 1.377 ± 1.47 mL/min/m2. On multivariate analysis, presence of diabetes mellitus ( p < 0.001), higher baseline residual GFR ( p < 0.001), hypotensive events ( p = 0.001), use of diuretics ( p = 0.002), and episodes of peritonitis ( p = 0.043) independently predicted faster decline of residual GFR. Male sex, old age, larger body mass index, and presence of coronary artery disease or congestive heart failure were also risk factors on univariate analysis. ⋄ Conclusions Our results suggested that diabetes mellitus, higher baseline residual GFR, hypotensive events, and use of diuretics are independently associated with faster decline of residual GFR in PD patients in Taiwan.

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