CLINICAL-EXPERIENCE AND MODEL ANALYSIS ON BETA-2-MICROGLOBULIN KINETICS IN HIGH-FLUX HEMODIALYSIS

Beta-2-microglobulin (beta2M) is associated with amyloidosis. The study of beta2M kinetics can provide information on the elimination of this uremic toxin. A beta2M kinetic model modified from Gotch, considering the volume changes between intracellular, interstitial, and intravascular compartments and the generation stimulation and inhibition during hemodialysis is proposed. The clinical experiments on 8 stable hemodialysis patients treated with polysulfone (F80) and polymethyl methacrylate (PMMA, BK2.1p) 3 times a week were conducted. There was an 18% decrease of beta2M clearance in the period from 30 to 180 min with a time-averaged beta2M clearance of 48 ml/min using polysulfone dialyzers (F80). In PMMA dialyzers, there was a 64% decrease of beta2M clearance from 30 to 180 min with a time-averaged clearance of 56.3 ml/min. During hemodialysis, the generation rate was 0.379 mg/min in polysulfone and 0.828 mg/min in PMMA dialyzers. There was a stimulation generation of 0.309 mg/min in polysulfone and 0.749 mg/min in PMMA during hemodialysis. In conclusion, we provide a beta2M kinetic model including volume changes, polymerization, generation stimulation, and inhibition that is similar to the human physiological condition. This model can be used for further clinical study.