Küchle C, Fricke H, Held E, Schiffl H
Department of Internal Medicine, Klinikum Innenstadt, University of Munich, Germany.
Am J Nephrol. 1996;16(6):484-8. doi: 10.1159/000169048.
Amyloidosis due to the retention of beta 2-microglobulin (beta 2-MG) is a frequent complication of hemodialysis (HD). Significant amounts of beta 2-MG can be removed from the body by highly permeable HD membranes, whereas conventional low-flux membranes are impermeable for the molecule. In a prospective and controlled study we investigated whether high-flux HD could delay the onset of dialysis-related amyloidosis (DRA). Twenty patients treated with cuprophane low-flux HD membranes were matched for age and previous time on HD either to continue their HD regimen or to receive HD treatment with high-flux polysulfone membranes. For 6 years each patient was examined for manifestations of DRA once a year or upon individual needs, additionally, serum beta 2-MG levels were monitored. After 6 years of follow-up no clinical signs of DRA were found in any of the patients dialyzed with high-flux polysulfone membranes, whereas 8/10 of the conventionally dialyzed patients had CTS and/or osteoarticular lesions. Serum levels of beta 2-MG were significantly reduced in patients treated with high-flux polysulfone membranes.
由β2-微球蛋白（β2-MG）潴留引起的淀粉样变性是血液透析（HD）常见的并发症。高通透性的HD膜可从体内清除大量β2-MG，而传统的低通量膜对该分子不可通透。在一项前瞻性对照研究中，我们调查了高通量HD是否能延缓透析相关淀粉样变性（DRA）的发生。20例使用铜仿低通量HD膜治疗的患者，根据年龄和既往HD时间进行匹配，一部分继续其HD治疗方案，另一部分接受高通量聚砜膜HD治疗。6年间，每年或根据个体需要对每位患者进行DRA表现检查，此外，监测血清β2-MG水平。随访6年后，使用高通量聚砜膜透析的患者均未发现DRA的临床体征，而传统透析的患者中有8/10出现了腕管综合征（CTS）和/或骨关节病变。使用高通量聚砜膜治疗的患者血清β2-MG水平显著降低。
