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      Call for Papers: Green Renal Replacement Therapy: Caring for the Environment

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      About Blood Purification: 3.0 Impact Factor I 5.6 CiteScore I 0.83 Scimago Journal & Country Rank (SJR)

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      Biomarkers for Evaluation of Clinical Outcomes of Hemodiafiltration

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      Publication date (Electronic):
      Journal: Blood Purification
      Publisher: S. Karger AG
      Keywords: Restless legs syndrome, β2-Microglobulin, α1-Microglobulin, Hemodiafiltration, Uremic toxins, Removal rate

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          Abstract

          β<sub>2</sub>-Microglobulin (β<sub>2</sub>-MG) is the substance that causes dialysis amyloidosis, and its predialysis value is useful for evaluating the quality of dialysis therapy itself. In addition, β<sub>2</sub>-MG is also an important biomarker for evaluating the removal performance of hemodialysis and hemodiafiltration (HDF). However, since β<sub>2</sub>-MG has a molecular weight of 11.8 kDa and can be efficiently removed by diffusion with existing high-performance dialyzers, a higher molecular weight substance should be used for evaluating removal performance of HDF, in which diffusion and convection are performed simultaneously. α<sub>1</sub>-Microglobulin (α<sub>1</sub>-MG) has a molecular weight of 33 kDa, and it is removed by convection during dialysis. When we used α<sub>1</sub>-MG to evaluate the removal performance of HDF in a study based on our own cases, we were able to describe the distinctive features and benefits of HDF with precision. α<sub>1</sub>-MG removal rate exactly paralleled the changes in symptoms. Kt/V and the β<sub>2</sub>-MG removal rate, however, did not undergo significant changes as the symptoms fluctuated. α<sub>1</sub>-MG should be used as a biomarker for evaluation of clinical outcomes of HDF.

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          Validation of the International Restless Legs Syndrome Study Group rating scale for restless legs syndrome.

          (2003)
          There is a need for an easily administered instrument which can be applied to all patients with restless legs syndrome (RLS) to measure disease severity for clinical assessment, research, or therapeutic trials. The pathophysiology of RLS is not clear and no objective measure so far devised can apply to all patients or accurately reflect severity. Moreover, RLS is primarily a subjective disorder. Therefore, a subjective scale is at present the optimal instrument to meet this need. Twenty centers from six countries participated in an initial reliability and validation study of a rating scale for the severity of RLS designed by the International RLS study group (IRLSSG). A ten-question scale was developed on the basis of repeated expert evaluation of potential items. This scale, the IRLSSG rating scale (IRLS), was administered to 196 RLS patients, most on some medication, and 209 control subjects. The IRLS was found to have high levels of internal consistency, inter-examiner reliability, test-retest reliability over a 2-4 week period, and convergent validity. It also demonstrated criterion validity when tested against the current criterion of a clinical global impression and readily discriminated patient from control groups. The scale was dominated by a single severity factor that explained at least 59% of the pooled item variance. This scale meets performance criteria for a brief, patient completed instrument that can be used to assess RLS severity for purposes of clinical assessment, research, or therapeutic trials. It supports a finding that RLS is a relatively uniform disorder in which the severity of the basic symptoms is strongly related to their impact on the patient's life. In future studies, the IRLS should be tested against objective measures of RLS severity and its sensitivity should be studied as RLS severity is systematically manipulated by therapeutic interventions.
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            Serum beta2-microglobulin level is a significant predictor of mortality in maintenance haemodialysis patients.

            Senji Okuno, K Kohno, Y Fujino … (2009)
            Beta(2)-microglobulin (beta(2)-M) is recognized as a surrogate marker of middle-molecule uraemic toxins and is a key component in the genesis of dialysis-associated amyloidosis. Few studies have evaluated the association of beta(2)-M levels with clinical outcome in dialyzed patients. The prognostic implication of serum beta(2)-M levels for the survival of haemodialysis patients was examined in 490 prevalent haemodialysis patients (60.1 +/- 11.8 years, haemodialysis duration of 87.4 +/- 75.7 months, 288 males and 202 females; 24% diabetics). The patients were divided into two groups according to their serum beta(2)-M levels: lower beta(2)-M group (n = 245) with serum beta(2)-M or=32.2 mg/L. During the follow-up period of 40 +/- 15 months, there were 91 all-cause deaths, and out of them, 36 were from cardiovascular diseases. Kaplan-Meier analysis revealed that all-cause mortality in the higher beta(2)-M group was significantly higher compared to that in the lower beta(2)-M group (P < 0.001). Multivariate Cox proportional hazards analyses showed that serum beta(2)-M level was a significant predictor for all-cause mortality (hazard ratio, 1.05; 95% CI, 1.01-1.08; P = 0.005), and for non-cardiovascular mortality (hazard ratio, 1.06; 95% CI, 1.02-1.10; P = 0.006), after adjustment for age, gender, haemodialysis duration, the presence of diabetes, serum albumin and serum C-reactive protein. These results demonstrate that the serum beta(2)-M level is a significant predictor of mortality in haemodialysis patients, independent of haemodialysis duration, diabetes, malnutrition and chronic inflammation, suggesting the clinical importance of lowering serum beta(2)-M in these patients.
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              A new form of amyloid protein associated with chronic hemodialysis was identified as β2-microglobulin

              F Gejyo, T Yamada, S Odani … (1985)
              Article 0 comments Cited 46 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (publisher-id): BPU
                Journal ID (nlm-ta): Blood Purif
                Journal ID (doi): 10.1159/issn.0253-5068
                Title: Blood Purification
                Publisher: S. Karger AG
                ISBN: 978-3-318-02338-1
                ISBN: 978-3-318-02339-8
                ISSN (Print): 0253-5068
                ISSN (Electronic): 1421-9735
                Publication date Subscription-year: 2013
                Publication date (Print): February 2013
                Publication date (Electronic): 25 February 2013
                Volume: 35
                Issue: Suppl 1
                Pages: 64-68
                Affiliations
                Hashimoto Clinic, Kanagawa, Japan
                Author notes
                *Kenji Sakurai, Hashimoto Clinic, 3-21-5, Hashimoto, Midori-ku Sagamihara-shi, Kanagawa 252-0143 (Japan), E-Mail ssakurai@peach.ocn.ne.jp
                Article
                Publisher ID: 346364 Other ID: Blood Purif 2013;35(suppl 1):64-68
                DOI: 10.1159/000346364
                PubMed ID: 23466382
                SO-VID: aac88598-a8eb-488a-81f3-0bc1ae73480c
                Copyright © © 2013 S. Karger AG, Basel
                License:

                Open Access License: This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) ( http://www.karger.com/OA-license), applicable to the online version of the article only. Distribution permitted for non-commercial purposes only. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

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                Figures: 4, Pages: 5
                Categories
                Subject: Paper

                ScienceOpen disciplines: Cardiovascular Medicine,Nephrology
                Keywords: Restless legs syndrome,β2-Microglobulin,α1-Microglobulin,Hemodiafiltration,Uremic toxins,Removal rate
                Data availability:
                ScienceOpen disciplines: Cardiovascular Medicine, Nephrology
                Keywords: Restless legs syndrome, β2-Microglobulin, α1-Microglobulin, Hemodiafiltration, Uremic toxins, Removal rate

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