Behavior of Beta 2-microglobulin (B2-m) serum levels in uremic patients

This Study Was Performed In 97 Hemodialysis Patients (85 On Hd And 12 On Capd) To Investigate The Possible Correlation Between B2-M And Hemodialysis-Related Amyloidosis Syndromes (Hra-S); Differences In B2-M And Hra Behavior Between Patients Hemodialysed With Cellulose And Synthetic Membranes Were Also Included In The Present Study. Data Indicate That B2-M Levels Are Not Correlated With Dialysis Length Or With The Type Of Membrane Used For The Dialysis. On The Contrary, In 16 Patients With The Carpal Tunnel Syndrome, A Significant Correlation Was Found Between The Cts, The Dialysis Length And The Type Of Membrane (Greater Incidence With Cellulosic Membranes).

Dieter Falkenhagen (1942–2015): A Multifaceted Scientist

Dieter Falkenhagen was born in 1942 in Dresden, Germany and died in 2015. He specialized in internal medicine and nephrology. Focusing on artificial organ research, he investigated various aspects of the efficacy and safety of hemodialysis and adsorption technologies, including biocompatibility issues related to blood versus surface interactions and the adverse effects of endotoxin contamination. He studied various mathematical models to analyze efficacy and safety, and animal models to help clarify uncertainty issues. Through his studies, adsorbents were developed, resulting in Prometheus, an artificial liver support device. Anticoagulation models, including citrate perfusion, were improved and made safer by his work. He also stepped into bioreactor research to increase efficacy of liver support devices.

Clinical evaluation of a new dialyzer, FLX-12 GW, with a polyester-polymer alloy membrane

The performance of a membrane in renal failure therapy is determined by its structure, its overall mass transfer properties, and its blood compatibility. In this regard, removal of beta 2-microglobulin (beta 2M) has become a major objective of dialysis therapy. In the present study, a newly developed high-flux membrane composed of a polyester-polymer alloy (PEPA) with the components of polyarylate and polyethersulfone (dialyzer FLX-12 GW; Nikkiso Co., Japan) has been evaluated with regard to both biocompatibility and elimination capacity for beta 2M during hemodialysis of 8 stable chronic uremic patients. The clearance values of low molecular weight solutes were in the same range as those reported for high-flux dialyzers of comparable surface area. There was no drop in leukocyte counts and only a minimal fall in platelet counts nearly in the same range as has been observed by other investigators using polyamide membrane. C3a Des Arg generation was low, and C5a Des Arg formation was not significantly influenced. There was a sharp drop in the serum beta 2M level (-35%) during dialysis with a clearance between 59.7 +/- 5.6 ml/min (QB 200 ml/min) and 70.1 +/- 9.7 ml/min (QB 300 ml/min), respectively. Accordingly, the sieving coefficient was calculated to be 0.2 at 30 min after start of dialysis and 0.6 1 h later. The membrane was able to remove 184.0 +/- 22.3 mg/4 h due to an apparent rate of adsorption during the first hour of treatment in combination with high transmembrane transfer in the following time.

[Serum level and organ deposits of beta 2-microglobulin in dialysis patients]

In radioimmunological estimation of beta 2-microglobulin (beta 2m) significant higher serum values were found in 36 dialysis patients (44.4 +/- 20.3 mg/l) in comparison with healthy probands (1.5 +/- 0.2 mg/l). A significant relation to the duration of dialysis, diuresis, symptoms of the musculo-skeletal system, but not to radiologic changes or bone biopsy findings could be seen. Post mortem examinations carried out in 21 dialysis patients revealed AB-amyloid deposits in synovial tissue of different joints (particularly shoulder and hip joint) or intervertebral discs in eight patients (age 48 to 73 years, dialysis duration less than four years) without correlation to serum beta 2m level or radiographically suspect areas. In the tissue of cervical spine or intervertebral discs of two patients suffering from destructive spondylarthropathy no amyloid could be detected. These results suggest that AB-amyloid may occur in elderly patients early in the course of hemodialysis and may be asymptomatic in most cases.