Red Blood Cell Function and β 2 Microglobulin Kinetics during Cuprophan Hemodialysis: A Hypothesis

Abstract

The exact role of β₂microglobulin (β₂m) in dialysis amyloidosis is yet not known. Local release of β₂m from the endothelial cells of the lung and other tissues as a consequence of acute-phase activation due to the contact of blood with membranes has still to be considered a possible pathogenetic factor in this syndrome. β₂m kinetics and decrease of glutathione content in RBC were studied in 41 chronic hemodialysis patients during cuprophan dialysis. The latter test reflects the RBC scavenger function for free oxygen radicals. Only 30% of patients showed a clinically significant increase in β₂m. The change in β₂m in this group between the start and 180 minutes, corrected for plasma volume, was 23.1±3.6% and the change in gluthathione content between the start and 15 minutes was 4.5±3.4%. In these patients there was a significant correlation between β₂m production and decrease of gluthathione (R= -0.61, p= 0.0299). It is possible that the production of free oxygen radicals during bioincompatible dialysis leads to cellular toxicity with release ofβ₂m which may be prevented to some extent by the scavenger role of RBC.