Clearance and synthesis rates of beta 2-microglobulin in patients undergoing hemodialysis and in normal subjects

Journal Article · Thu Aug 01 04:00:00 EDT 1991 · Journal of Laboratory and Clinical Medicine; (United States)

OSTI ID:5460240

Floege, J; Bartsch, A; Schulze, M; Shaldon, S; Koch, K M; Smeby, L C ^[1]

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1. Department of Nephrology, University Hospital of Hannover (Germany)

Retention of {beta} 2-microglobulin in patients undergoing hemodialysis is associated with a {beta} 2-microglobulin-derived amyloidosis. Removal of {beta} 2-microglobulin by renal replacement therapy has been proposed for the prevention of this amyloidosis. Currently, however, data on the {beta} 2-microglobulin synthesis rate in patients undergoing hemodialysis are scarce, and consequently it remains speculative how much removal would be necessary to counterbalance synthesis. The plasma kinetics of iodine 131-labeled {beta} 2-microglobulin were therefore examined in 11 patients with anuria who were undergoing long-term hemodialysis. Five healthy persons served as controls. Kinetic modeling of the plasma curves showed that the data fitted a two-pool model (r2 greater than 0.96) consisting of a rapid 2 to 4 hour distribution phase followed by a less steep curve, described by the plasma (metabolic) clearance (Clp). Synthetic rates were calculated from Clp and the {beta} 2-microglobulin steady state plasma concentration (plus {beta} 2-microglobulin removal during hemodialysis in the case of high flux hemodialysis). The results showed a significantly higher Clp in normal controls as compared with patients undergoing hemodialysis (65.5 {plus minus} 12.8 ml/min (mean {plus minus} SD) versus 3.4 {plus minus} 0.7 ml/min). In contrast, the {beta} 2-microglobulin synthesis rate in the patient group (3.10 {plus minus} 0.79 mg/kg/day) was not significantly different from that of normal controls (2.40 {plus minus} 0.67 mg/kg/day), which was due to markedly elevated {beta} 2-microglobulin plasma concentrations in the patients (37.6 {plus minus} 14.1 mg/L vs 1.92 {plus minus} 0.27 mg/L). These findings suggest that the presence of end-stage renal disease does not have a significant impact on the beta 2-microglobulin generation rate.

• OSTI ID: 5460240
• Journal Information: Journal of Laboratory and Clinical Medicine; (United States), Journal Name: Journal of Laboratory and Clinical Medicine; (United States) Vol. 118:2; ISSN JLCMA; ISSN 0022-2143
• Country of Publication: United States
• Language: English

Related Subjects

550901* -- Pathology-- Tracer Techniques
59 BASIC BIOLOGICAL SCIENCES
ARTIFICIAL ORGANS
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BLOOD-PLASMA CLEARANCE
BODY
CLEARANCE
DAYS LIVING RADIOISOTOPES
DIALYSIS
DISEASES
GLOBULINS
GLOBULINS-BETA
INTERMEDIATE MASS NUCLEI
IODINE 131
IODINE ISOTOPES
ISOTOPE APPLICATIONS
ISOTOPES
KIDNEYS
MECHANICAL KIDNEY
MEDICAL SUPPLIES
NUCLEI
ODD-EVEN NUCLEI
ORGANIC COMPOUNDS
ORGANS
PATHOGENESIS
PATIENTS
PROSTHESES
PROTEINS
RADIOISOTOPES
SEPARATION PROCESSES
TRACER TECHNIQUES
UROGENITAL SYSTEM DISEASES