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Arresting Dialysis-Related Amyloidosis: A Prospective Multicenter Controlled Trial of Direct Hemoperfusion with a β2-Microglobulin Adsorption Column

Authors


Dr. Fumitake Gejyo, Division of Clinical Nephrology and Rheumatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi, Niigata 951-8510, Japan. E-mail: gejyo@med.niigata-u.ac.jp

Abstract

Abstract:  We investigated the clinical efficacy of direct hemoperfusion with a β2-microglobulin (β2-m) adsorption column for the treatment of patients with dialysis-related amyloidosis. A 2-year prospective controlled study was performed to compare the effects of passaging blood through a (β2-m) adsorption column (Lixelle) before it is passaged through the dialysis polysulfone membrane on the severity of amyloidosis in these individuals. Patients (n = 22) whose blood went through the Lixelle column prior to dialysis had a higher β2-m removal rate compared to an equal number of controls, and they showed earlier improvement in their symptoms which included impaired daily  activities,  joint  stiffness,  and  pain.  The  appearance of additional bone cysts was prevented in pre-adsorbed patients but not in the controls. Thus, the Lixelle column is useful in preventing the progression of dialysis-related amyloidosis and in ameliorating or arresting the progression of the  symptoms  of  this  disorder.

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