Long-Term Variations of Serum Beta2-Microglobulin Levels in Hemodialysed Uremics according to Permeability and Bioincompatibility of Dialysis Membranes

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Abstract
Hemodialysis (HD) amyloidosis is due to .beta.2-microglobulin (.beta.2M) storage, the importance of which could vary with the permeability of dialysis membranes. We studied long-term variations of .beta.2M in 52 patients who had been dialyzed over 1.5-20 years (mean .+-. SD = 7.5 .+-. 5.2), 3 .times. 4 h weekly. Serum samples had been stored at 30.degree.C and RIAs were done in one run with the same kits (Immunotech). At least 2 assays were done for each patient in samples collected 1-9.5 years apart. Mean .beta.2M concentration in 26 ESRF patients was 31 .+-. 18 mg/l. According to duration of HD and membranes used, Cuprophan (CUP) versus polyacrylonitrile (AN69), mean concentrations of .beta.2M were (mg/l .+-. SD): at 6 months, 55 .+-. 36 vs. 54 .+-. 20 (n.s.); 2 years, 55 .+-. 24 vs. 61 .+-. 23 (n.s.); 4 years, 79 .+-. 18 vs. 64 .+-. 19 (n.s); 6 years, 69 .+-. 17 vs. 55 .+-. 17 (n.s.); 8 years, 76 .+-. 18 vs. 54 .+-. 12 (< 0.01); 10 years, 77 .+-. 17 vs. 54 .+-. 14 (< 0.02). The effect of changing membranes was also studied: CUP-AN69 (69 .+-. 28 months), 79 .+-. 21 vs. 54 .+-. 14 (< 0.01). Serum .beta.2M (1) increased rapidly after the beginning of HD; (2) reached a plateau after 2 years in patients treated with AN69 and 4 years with CUP; (3) were significantly lower after 8 years with AN69 than with CUP, and (4) decreased significantly after changing CUP for AN69. These data suggest that high permeability membranes might prevent or delay the occurrence of HD amyloidosis.

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