Hönig R, Marsen T, Schad S, Barth C, Pollok M, Baldamus C A
Department of Nephrology, Medical Clinic I, University of Cologne, FRG.
Int J Artif Organs. 1988 Nov;11(6):459-64.
Plasma and ultrafiltrate beta-2-microglobulin (B2M) concentrations were determined during hemofiltration (HF) and hemodialysis (HD) in order to evaluate elimination kinetics of B2M. Calculations were done on the basis of plasma-water-concentrations (PWC). Elimination of B2M during HF follows first order kinetics (r = 0.97) and the volume of B2M distribution was calculated to be 17 +/- 2% of body weight. This reflects extracellular volume (ECV). Changes of ECV in HD were induced by weight loss and further provoked by fluid shifts from intra- to extracellular volume and vice versa induced by varying dialysate sodium concentration. These ECV changes were followed by determining inuline in plasma and total dialysate. Changes of B2M concentration correlate well to changes of ECV (r = 0.98). Thus intratreatment concentration changes of B2M in cuprophane dialysis reflect simultaneous changes of B2M distribution volume. This does not exclude the possibility of B2M generation stimulated by dialysis, but proving such effects in vivo will be difficult because of multiple variants, that must be controlled.
为评估β2微球蛋白(B2M)的清除动力学,在血液滤过(HF)和血液透析(HD)过程中测定了血浆和超滤液中B2M的浓度。计算基于血浆水浓度(PWC)。HF过程中B2M的清除遵循一级动力学(r = 0.97),计算得出B2M的分布体积为体重的17±2%。这反映了细胞外液量(ECV)。HD中ECV的变化由体重减轻引起,并因透析液钠浓度变化导致的细胞内液与细胞外液之间的液体转移而进一步加剧。通过测定血浆和总透析液中的菊粉来跟踪这些ECV变化。B2M浓度的变化与ECV的变化密切相关(r = 0.98)。因此,铜仿膜透析过程中B2M的治疗中浓度变化反映了B2M分布体积的同时变化。这并不排除透析刺激B2M生成的可能性,但由于必须控制多种变量,在体内证明这种作用将很困难。