Effect of β2-microglobulin adsorption column on dialysis-related amyloidosis

Background. beta(2)-microglobulin (beta(2)-m) is considered a major pathogenic factor in dialysis-related amyloidosis (DRA), often seen in long-term dialysis patients. No effective therapy for this severely debilitating disease is currently available. Lixelle(TM), an adsorption column, has been developed for the elimination of beta(2)-m; the efficacy of this column has been evaluated in this study. Methods. Seventeen hemodialysis patients with DRA were first treated with high-flux dialysis for a minimum of 1 year. This was followed by 1-year treatment with Lixelle(TM) column connected in series to the high-flux dialyzer. Treatments were used three times a week for both phases of this study. During the study period, beta(2)-m, pinch strength, motor terminal latency, and activities of daily living were evaluated. Results. After 1-year treatment with high-flux dialysis the beta(2)-m level remained unchanged; however, after 1-year treatment with the addition of the Lixelle(TM) column, beta(2)-m level decreased significantly from 34.5 +/- 8.4 mg/L to 28.8 +/- 7.3 mg/L (P < 0.05). After 1 year of Lixelle(TM) column use, the pinch strength increased from 6.8 ± 4.7 pounds to 9.1 ± 5.5 pounds (P < 0.01), and the median motor terminal latency was significantly reduced from 5.1 +/- 1.0 mseconds to 4.5 +/- 1.1 mseconds. A significant improvement was also observed in the activities of daily living score of the upper extremities. Conclusion. These results suggest that the addition of Lixelle(TM) to the high-flux dialyzer is associated with a significant clinical improvement in DRA patients.