Beta-2-Microglobulin Generation Rate and Clearance Rate in Maintenance Hemodialysis Patients

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Abstract
We analyzed the rebound pattern of plasma β2-microglobulin (β2-m) concentration from 4 h after completion of hemodiafiltration until the start of the next treatment according to the one-pool β2-m kinetic model so as to determine β2-m generation rate and whole-body β2-m clearance. Next, we obtained the whole renal β2-m clearance as the product of renal creatinine clearance and the glomerular sieving coefficient of β2-m. Then, extrarenal β2-m clearance was calculated as the difference between whole-body β2-m clearance and whole renal β2-m clearance, and renal β2-m clearance due to tubular absorption was taken to be the difference between whole renal β2-m clearance and renal β2-m clearance due to urinary excretion. The results showed that the β2-m generation rate was virtually the same for all patients and that the higher the patients and that the higher the patients’ plasma β2-m concentration was, the lower was the whole-body β2-m clearance. Moreover, in the present study, an inverse correlation was found between the following respective factors: plasma β2-m concentration and whole renal β2-m clearance; plasma concentration and renal clearance due to tubular absorption; plasma concentration and renal clearance due to urinary excretion. However, there was no correlation between plasma β2-m concentration and extrarenal β2-m clearance. The findings indicate that the variation of plasma β2-m concentration with the individual patient is solely attributable to the variation in residual renal function in terms of β2-m elimination.