Kinetics of beta2-microglobulin and phosphate during hemodialysis: effects of treatment frequency and duration.

摘要: Current understanding of beta2-microglobulin (beta2M) and phosphate (or inorganic phosphorus) kinetics during hemodialysis is reviewed. The postdialysis:predialysis concentration ratio for beta2M determined by dialyzer clearance beta2M, treatment time, patient body size (specifically, extracellular fluid volume), total ultrafiltration volume the treatment. Evaluation these parameters can be used to calculate beta2M; however, such calculated values are only approximations, since they neglect intradialytic generation, nonrenal (nondialyzer) clearance, postdialysis rebound beta2M. detailed best described using a two-compartment model. Theoretical predictions from models suggest that product weekly duration, independent frequency, main determinant plasma concentrations. removal incompletely understood. Phosphate removed both intracellular compartments hemodialysis; levels off after first 1 or 2 hours concentrations even before therapy complete. Increases in have been previously achieved increasing dialysis membrane surface area use hemodiafiltration. A four-compartment model proposed recently Spalding et al. suggests major barrier limited transfer between compartments, although other complex factors also play important roles. either frequency duration increase removal. representative middle molecules whose governed predominantly at dialyzer. In contrast, primarily its sequestration compartment (and possibly compartments), not may therefore uremic toxins into protein binding. Enhanced given will require treatments increased longer duration.