Beta-2 Microglobulin Levels in Haemodialysis Patients before and after Shifting to High Flux Dialysis Membranes

Objective: β2-Microglobulin is recognized as a surrogate marker of middle-molecule uremic toxins and is a key component in the genesis of dialysis-associated amyloidosis. The main objective of the present study was to compare the serum level of β 2 microglobulin in CRF patients on hemodialysis using low flux membranes and high flux ones. Patients and methods: This prospective study was conducted at the hemodialysis unit of the Pediatric Nephrology Department, Cairo University New Children s hospital. It included 20 children between 10 - 15 years, with ESRD who were on regular hemodialysis with low flux dialysis membranes. The following clinical and laboratory variables were evaluated while the patients were on the low flux and after using high flux membranes for 3 consecutive months; weight , blood pressure , complete blood count, serum BUN, creatinine, Na, K, Ca, PO4, albumin, as well as β2 microglobulin level. Results: Post dialysis urea, creatinine and phosphorus levels were significantly lower on the high flux than on the low flux dialyzers but there was no observed difference in sodium levels, potassium or albumin levels. Hemoglobin and hematocrit levels on high flux dialyzers were 11.55 gram/dl and 33.58 % respectively, significantly higher than that on low flux ones, (9.69 gram/dl and 26.96 % respectively).β 2 microglobulin levels on the high flux dialyzer were 3.42±0.55 mg/L, while on the low flux they were 10.96±2.70 mg/L, the difference was statstically signifcant (p- value 0.001) the percent of reduction was 67.2%. Conclusion: High-flux dialysis membranes are associated with significant higher removal of β2 microglobulin and other uremic toxins than the low flux membranes. The benefits of using high flux membranes are delaying the onset and minimizing the complications of dialysis-related amyloidosis.