scholarly journals Incremental Hemodialysis Schedule in Patients with Higher Residual Renal Function at the Start of Dialysis

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Milagros Fernández Lucas ◽  
José Luis Teruel ◽  
Gloria Ruíz-Roso ◽  
Martha Díaz ◽  
Viviana Raoch ◽  
...  
Keyword(s):  
Renal Function ◽  
Cost Effective ◽  
Clinical Situation ◽  
Residual Renal Function ◽  
Additional Benefit ◽  
Weekly Schedule ◽  
Decline Rate ◽  
Incremental Hemodialysis ◽  
Beta 2 ◽  
Beta 2 Microglobulin

We present an observational study to evaluate a progressive schedule of dose of dialysis, starting with 2 HD/week, when the renal clearance of urea was equal to or greater than 2,5 mL/min/1,73 m2 and the patient is in a stable clinical situation. From 2006 to 2011, 182 patients started hemodialysis in our center, of which 134 were included in the study. Residual renal function (RRF), Kt/V, eKru, nPCR, hemoglobin, weekly erythropoietin dose, and beta-2-microglobulin were determined at 6, 12, 18, 24, and 30 months after dialysis initiation. Seventy patients (52%) began with the progressive schedule of 2 HD/week and 64 (48%) patients began with the conventional thrice-weekly schedule (3 HD/week). The decline of RRF was lower in the group of 2 HD/week: 0,20 (0,02–0,53) versus 0,50 (0,14–1,08) mL/min/month (median and interquartile range, P=0,009). No relationship was found between the decline rate and the basal RRF. Survival analysis did not show differences between both groups. Our experience demonstrates that patients with higher residual renal function may require less than conventional 3 HD sessions per week at the start of dialysis. Twice-weekly hemodialysis schedule is safe and cost-effective and may have additional benefit in maintaining the residual renal function.

Serum Beta-2-Microglobulin Level and Residual Renal Function in Peritoneal Dialysis

Nephron ◽  
1993 ◽  
Vol 65 (3) ◽  
pp. 469-471 ◽  
Author(s):  
Gianpaolo Amici ◽  
Giovambattista Virga ◽  
Giorgio Da Rin ◽  
Stefano Grandesso ◽  
Alberto Vianello ◽  
...  
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Residual Renal Function ◽  
Beta 2 ◽  
Beta 2 Microglobulin

scholarly journals MP547CYSTATIN C AND BETA-2 MICROGLOBULIN - VALUABLE BIOMARKERS OF RESIDUAL RENAL FUNCTION IN PERITONEAL DIALYSIS

2017 ◽  
Vol 32 (suppl_3) ◽  
pp. iii629-iii630
Author(s):  
Carla Moreira ◽  
Liliana Cunha ◽  
Maria Carvalho ◽  
José Oliveira ◽  
Olívia Santos ◽  
...  
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Residual Renal Function ◽  
Beta 2 ◽  
Beta 2 Microglobulin

scholarly journals The effect of membrane biocompatibility on plasma beta 2-microglobulin levels in chronic hemodialysis patients.

1996 ◽  
Vol 7 (3) ◽  
pp. 472-478
Author(s):  
R M Hakim ◽  
R L Wingard ◽  
L Husni ◽  
R A Parker ◽  
T F Parker
Keyword(s):  
Renal Function ◽  
Medical Center ◽  
Residual Renal Function ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
High Flux ◽  
Rate Of Increase ◽  
Beta 2 ◽  
Lower Plasma Level ◽  
Beta 2 Microglobulin

Several studies have shown that patients who have been dialyzed with high-flux biocompatible membranes have a lower plasma level of beta 2-microglobulin and a lower incidence of amyloid disease compared with patients who have been dialyzed with low-flux bioincompatible membranes. However, because high-flux membranes are associated with significant dialytic removal of beta 2-microglobulin, the specific role of membrane biocompatibility in influencing the rate of increase of beta 2-microglobulin has not been previously determined. This study investigated the effect of biocompatibility on the rate of increase of plasma levels of beta 2-microglobulin in 159 new hemodialysis patients from 13 dialysis centers (ten centers affiliated with Dallas Nephrology Associates and three with Vanderbilt University Medical Center) by using two low-flux membranes with widely different biocompatibilities. These patients were prospectively randomized to be dialyzed with either a low-flux biocompatible membrane or a low-flux bioincompatible membrane. Plasma beta 2-microglobulin levels were measured at 0, 3, 6, 9, 12, and 18 months. Sixty-six patients completed the 18-month study. Plasma beta 2-microglobulin increased in all patients; however, the increase was not significantly different from baseline at any time point in the group that used the biocompatible membrane. In this group, beta 2-microglobulin increased from (mean +/- SD) 27.8 +/- 14.8 mg/L to 34.0 +/- 10.0 mg/L at 18 months (P = not significant), and the mean increase at 18 months was 2.6 +/- 14.7 mg/L. In contrast, the increase in plasma beta 2-microglobulin level in the bioincompatible membrane group became significant in Month 6 when the levels had increased from a baseline of 24.8 +/- 9.6 mg/L to 29.5 +/- 12.2 mg/L (P < 0.001); these increases continued to be significant until Month 18, when serum beta 2-microglobulin reached 36.8 +/- 13.9 mg/L with an average increase of 11.8 +/- 11.2 mg/L (P < 0.0001). The higher rate of plasma B2-microglobulin increase in the group that had been dialyzed with the bioincompatible membrane was also evident when only patients who had completed the study were analyzed. There were no significant differences in the actual level of beta 2-microglobulin or in residual renal function between the two groups during the 18 months of the study. It was concluded that over a period of 18 months, the use of biocompatible membranes, even in the low-flux configuration, is associated with a significantly slower increase in plasma beta 2-microglobulin, independent of the influence of residual renal function.

scholarly journals Online hemofiltration in incremental dialysis prescription

2021 ◽  
Vol 34 (4) ◽  
Author(s):  
Sofia Correia ◽  
◽  
Filipa Silva ◽  
Joana Tavares ◽  
António Cabrita ◽  
...  
Keyword(s):  
Renal Function ◽  
Potential Benefit ◽  
Residual Renal Function ◽  
Additional Benefit ◽  
Dialysis Adequacy ◽  
Major Complications ◽  
Incremental Hemodialysis

Incremental dialysis is increasingly recognized as a safe and beneficial method of initiating dialysis. Different centers use distinct prescription methods. We discuss the advantages of incremental hemodialysis and the potential benefit of preserving residual renal function as we present our experience. We reviewed the data from 20 incident patients, with a mean follow‑up of 9.5 months, who started dialysis with our prescription method, using hemofiltration as the preferred depurative technique. All patients tolerated treatment well; no major complications were reported. Dialysis adequacy targets were achieved. While data are clearly limited, we raise the hypothesis that convective techniques could bring additional benefit in preserving residual renal function in incident patients, and that this strategy should be studied and compared with others.

scholarly journals DIAGNOSTIC SIGNIFICANCE OF BETA 2-MICROGLOBULIN IN THE ASSESSMENT OF NEONATAL RENAL FUNCTION

1984 ◽  
Vol 18 ◽  
pp. 357A-357A
Author(s):  
Farahnak K Assadi ◽  
Eunice G John ◽  
Dharmapuri Vidyasagar ◽  
Parvin Justice ◽  
Linda Fornell
Keyword(s):  
Renal Function ◽  
Diagnostic Significance ◽  
Beta 2 ◽  
Beta 2 Microglobulin

Beta-2 microglobulin (B2M) is an independent prognostic factor for clinical outcomes in patients with CLL treated with frontline fludarabine, cyclophosphamide, and rituximab (FCR) regardless of age, creatinine clearance (CrCl)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 7034-7034 ◽  
Author(s):  
A. M. Tsimberidou ◽  
C. Tam ◽  
W. Wierda ◽  
S. O' Brien ◽  
S. Lerner ◽  
...  
Keyword(s):  
Renal Function ◽  
Prognostic Factor ◽  
Clinical Outcomes ◽  
The Other ◽  
Adverse Prognostic Factor ◽  
Younger Age ◽  
Beta 2 ◽  
Beta 2 Microglobulin ◽  
Independent Adverse Prognostic Factor

7034 Introduction: High β2M levels are a risk factor in CLL. PCR therapy has been reported to be better tolerated than FCR in older or with decrease renal function pts (Shanafelt, Blood 108:15a). We assessed the association between age, CrCl, PS, β2M and outcomes in pts treated with FCR. Methods: From 7/99 to 1/04, 300 pts received rituximab 375 mg/m2 D1; fludarabine 25 mg/m2/d D2–3; and cyclophosphamide 250 mg/m2/d D2–3. Serum β2M levels were measured by radioimmunoassay. CrCl was calculated (Cockcroft-Gault equation). Results: The median age was 57 yrs (≥70, 14%). Age ≥70 was associated with fewer FCR courses (p<.0001); lower rates of CR (p=.001), overall response (OR; p=.04), survival (OS; p<.0001), and FFS (p=.008); and higher rates of G3–4 thrombopenia (p<.0001) or anemia (p=.002) compared with age<70. The median CrCl was 90 mL/min (CrCl <70, 27%). Pts with CrCl <70 had higher rates of G3–4 thrombopenia (p=.006) or anemia (p=.01) than others. There were no differences between the 2 groups in the other outcomes. PS was 0 in 40%, 1 in 57%, and 2 in 3% of pts. Better PS was associated with higher rates of CR (p=.007) and FFS (p=.02) but did not affect OR or OS. The median β2M level was 3.7 mg/L (β2M ≥ 4, 43%). The rates of CR, survival, and FFS were lower in pts with β2M ≥ 4 compared with others (p<.0001 each). High β2M levels were associated with older age, lower CrCl levels, poorer PS (p<.0001 each), higher rates of G3–4 neutropenia (p=.005), thrombocytopenia (p=.01), and infections (p=.03), and fewer FCR courses (p=.004). The median follow-up was 5 yrs. The rates of CR, 3-yr OS and 3-yr FFS were 72%, 87% and 76%, respectively. Independent factors predicting response were lower β2M (p=.0004) and lower WBC counts (p=.02). Independent factors predicting longer OS were younger age (p=.001), lower β2M (p=.003) and lower WBC (p=.03). Independent factors predicting longer FFS were lower β2M levels (p=.0006), and lower WBC counts (p=.005). Conclusion: Age ≥70 yrs and poor PS, but not CrCl level were associated with poor clinical outcomes. High β2M levels are an independent adverse prognostic factor for CR, OS, and FFS in the context of other prognostic factors. No significant financial relationships to disclose.

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