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dc.contributor.authorHaase, Men
dc.contributor.authorBellomo, Rinaldoen
dc.contributor.authorBaldwin, Ian Cen
dc.contributor.authorHaase-Fielitz, Anjaen
dc.contributor.authorFealy, Nigel Gen
dc.contributor.authorMorgera, Stanislaoen
dc.contributor.authorGoehl, Hermannen
dc.contributor.authorStorr, Men
dc.contributor.authorBoyce, Neilen
dc.contributor.authorNeumayer, H-Hen
dc.identifier.citationThe International Journal of Artificial Organs; 30(5): 385-92en
dc.description.abstractbeta2-microglobulin (beta2MG) is pivotal to the pathogenesis of dialysis-related amyloidosis. We compared the effects of high cut-off hemodialysis (HCO-HD) with those of standard high-flux hemodialysis (HF-HD) regarding the concentration and clearance of beta2MG and albumin.We enrolled ten patients with acute renal failure in a double-blind, cross-over, randomized controlled trial.Each patient received four hours of HCO-HD (estimated in vivo cutoff 50-60 kDa) and four hours of HF-HD (estimated in vivo cutoff 15-20 kDa) in random order. Statistical methods and outcome measures: As data lacked normal distribution, we used nonparametric statistical analysis. Plasma and dialysate concentrations of beta2MG and albumin were measured at baseline and after four hours of each study treatment.We found significantly greater diffusive beta2MG clearances for HCO-HD compared to HF-HD (at the start: 71.8 ml/min vs. 5.1 ml/min; P=0.008 and at the end: 68.8 ml/min vs. 5.7 ml/min; P=0.008). We found a reduction in plasma beta2MG concentrations of -31.6% during HCO-HD compared to an increase by 25.7% during HF-HD; P=0.008. At baseline (HCO-HD: 26.0 g/L vs. HF-HD: 26.5 g/L), and at the end of both treatments, plasma albumin concentrations were comparable (HCO-HD: 25.5 g/L vs. HF-HD: 26.5 g/L; P=0.25). During HCO-HD, albumin clearance was 1.9 ml/min at the start and decreased significantly to 0.8 ml/min at the end; P=0.008. HF-HD had an albumin clearance of 0.01 ml/min.HCO-HD was more effective in decreasing plasma beta2MG concentrations than standard HF-HD and did not reduce plasma albumin levels. Further studies of HCO-HD in the treatment of dialysis-related beta2MG accumulation appear warranted.en
dc.subject.otherAcute Kidney Injury.blood.therapyen
dc.subject.otherCross-Over Studiesen
dc.subject.otherDouble-Blind Methoden
dc.subject.otherMiddle Ageden
dc.subject.otherRenal Dialysis.methodsen
dc.subject.otherSerum Albumin.analysisen
dc.subject.otherbeta 2-Microglobulin.blooden
dc.titleBeta2-microglobulin removal and plasma albumin levels with high cut-off hemodialysis.en
dc.typeJournal Articleen
dc.identifier.journaltitleInternational Journal of Artificial Organsen
dc.identifier.affiliationIntensive Care Research, Austin Hospital, University of Melbourne, Australiaen
dc.type.austinJournal Articleen, Ian C
item.fulltextNo Fulltext-
item.openairetypeJournal Article-
item.cerifentitytypePublications- Care- Analytics Research and Evaluation (DARE) Centre- Care- Care-
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